Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Is this scalp swelling normal?

E-9-1-1 152

E-9-1-1 Plasma Emergency Department OR 152

Core EM

JANUARY 24, 2024

Published 2019 Jun 6. Anticoagulant Reversal Strategies in the Emergency Department Setting: Recommendations of a Multidisciplinary Expert Panel. Ann Emerg Med. Background Around 6 million people in the U.S. Reversal of oral anticoagulation in patients with acute intracerebral hemorrhage. 2019;23(1):206.

FFP 130

FFP Frozen Plasma Plasma ALS 130

Don't Forget the Bubbles

JUNE 30, 2023

This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

EMDocs

JULY 11, 2023

The patient’s plasma is mixed with normal pooled plasma (NPP) which adds sufficient clotting factors to overcome the deficiency. If an inhibitor is present, it will inhibit the clotting factors in patient plasma and the NPP, and the clotting time remains prolonged. Each unit of FVIII/kg raises the plasma FVIII level by 2%.

Plasma 62

Plasma ALS OR Emergency Department 62

Don't Forget the Bubbles

AUGUST 12, 2024

What neuroprotective measures can we undertake in the emergency department? Neuroprotective measures are undertaken in the emergency department and PICU to optimise intracerebral conditions, minimise secondary brain injury, and create optimal tissue healing conditions. 2019 Apr;20(4):404]. Published 2019 Nov 27.

ALS 75

ALS Emergency Department Plasma OR 75

EMDocs

SEPTEMBER 7, 2023

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. 2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergency department. McGraw Hill, 2019. McGraw Hill, 2019.

E-9-1-1 66

E-9-1-1 ALS Emergency Department Plasma 66

EMDocs

JUNE 7, 2023

8 Plasma butyrylcholinesterase (“pseudocholinesterase”) activity Easier to assay and is more widely available Red cell acetylcholinesterase (“true cholinesterase”) activity More accurate and specific Management: Patients require immediate intervention if there is concern for acute organophosphate poisoning. BMC Res Notes. 2013; 6:524.

E-9-1-1 84

E-9-1-1 ICU Emergency Department ED 84