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Rebaked: Inborn Errors of Metabolism presenting in the ED

Pediatric EM Morsels

Let’s consider Inborn Errors of Metabolism Presenting in the ED : Inborn Errors of Metabolism: Basics Common Presentations, Uncommon Kiddos For the child with lethargy, vomiting, acidosis, hypoglycemia , organomegaly, or cardiopulmonary arrest remember to consider Inborn Errors of Metabolism (IEM) on your DDx. Pediatrics. Samantha A.

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SGEM#368: Just A Normal Saline Day in the ICU – The PLUS Study

The Skeptics' Guide to EM

Date: June 12th, 2022 Reference: Finfer et al. Date: June 12th, 2022 Reference: Finfer et al. sodium chloride), and balanced crystalloid solutions, meaning those with a chloride composition closer to plasma such as lactated ringer’s or Plasma Lyte 148. Early work suggested potential harm from 0.9%

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Congenital Syphilis

Pediatric EM Morsels

Early Congenital Syphilis Present before 2 years of age [ Hussain, 2023 ; Foles, 2024; Fang, 2022; Morrisroe, 2021 ] Only ~33% of newborns present with symptoms at birth and can be subtle. Congenital Syphilis may still occur in patients presenting to your ED! 2022 Dec 27;14(12):e33009. Most will develop signs by 3 months of age.

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Anti-NMDA Receptor Encephalitis in Children and Adolescents

Pediatric EM Morsels

It is commonly missed during the first few ED visits. First line therapies for anti-NMBDA receptor encephalitis consists of… High dose steroids , IVIG, and PLEX – Therapeutic plasma exchange Only 50% of patient’s respond, and will require second line therapies such as Rituximab. 2022 Jul 6;9(5):e200013. doi: 10.1212/NXI.0000000000200013.

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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

These medications are a vital tool in the care of ED patients, from simple local analgesia for a laceration repair to regional analgesia for painful procedures. Metabolism of ester anesthetics is by plasma cholinesterase, whereas amides are metabolized by the cytochrome P450 system in the liver. [6] McGraw Hill; 2022.

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ToxCard: Diethylene Glycol

EMDocs

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. “Diethylene Glycol” in Goldfrank’s Toxicologic Emergencies , 11e Eds. Accessed August 2022. FDA Consumer Magazine , June 1981, [link] Accessed August 2022. Schier, Capt.

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Cholera: ED presentation, evaluation, and management

EMDocs

Louis) // Reviewed by: Joshua Lowe, MD (EM Staff Physician, USAF); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 25-year-old woman presented to the emergency department (ED) in Uganda with acute encephalopathy. How is this condition diagnosed and treated in the ED? Published online November 14, 2022.

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