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TXA (Tranexamic Acid) in Pediatrics 

Pediatric EM Morsels

TXA has been mentioned previously on PEM Morsels in the following contexts: Post Tonsillectomy Hemorrhage , Hemophilia in the ED , Von Willebrand Disease , Epistaxis in Children , Hereditary Angioedema , Hemoptysis in Children , Hyphema , and even in Neonatal Subgaleal Hemorrhage. 2012 Feb;147(2):113-9. 2020;2(1):e0075.

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High sensitivity cardiac troponins for ED chest pain evaluation (2022 ACC pathway)

ALiEM

The 2022 American College of Cardiology (ACC) pathway provides timely guidance [1]. Encourage your ED to set up an algorithm that you can follow based on your laboratory’s assay. Low-risk patients do not routinely require stress testing in the ED. We help you translate this to your clinical practice, by illustrating with a case.

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emDOCs Revamp: Alcohol Withdrawal

EMDocs

What is the next step in evaluation and treatment? fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

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ED Management of Minor Thermal Burns

Core EM

7 86% of burn injuries are thermal burns (as opposed to chemical or electric), with 43% resulting from a direct exposure to fire, 34% from scalding liquid, and 9% from a hot object. 9 Apply a topical antimicrobial (eg. Br Med J (Clin Res Ed). 2004 Jun 19;328(7454):1487-9. Tintinalli, et al. 1987 Jul 18;295(6591):181.

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EM@3AM: Murine Typhus

EMDocs

A 52-year-old male with a history of essential hypertension presents to your South Texas ED for his second visit this week complaining of indolent fever, shortness of breath, pleuritic chest pain, and a rash on his trunk and extremities. We’ll keep it short, while you keep that EM brain sharp.

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Congenital Pulmonary Airway Malformation (CPAM)

Pediatric EM Morsels

I’m sure you can recall at least several parents who bring their children into the ED for concern of recurrent pneumonias. References Dessole F, Virdis G, Andrisani A, Vitagliano A, Cappadona R, Dessole S, Cosmi E, Capobianco G. Leblanc C, Baron M, Desselas, E, Phan, MH, Rybak A, Thouvenin G, Lauby C, Irtan S. Dec: 9 (12): 1830.

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emDOCs Podcast – Episode 110: Primary Spontaneous Bacterial Peritonitis

EMDocs

Commonly a monomicrobial infection with gram-negative bacteria like E. Major takeaway: Consider SBP in any patient who comes into the ED with ascites. Paracentesis is a safe procedure with a low complication rate (< 1%). g/kg of 20% albumin IV at the time of diagnosis and 1 g/kg IV 48 hours later. Dosing is 1.5

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