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Since tonsillectomy is one of the most common pediatric surgeries in the US (~500,000 per year) and the rate of post-tonsillectomy hemorrhage is about 1-5% , it is a good idea that we all are familiar with how to manage this issue! 2020 Sep;38(9):1943. Rohe E, Gresham M, Rohde R, Cass L, Brinkmeier JV, Childers A. 2020.01.042.
Pathophysiology Primary injury happens at the time of the traumatic event or shortly after in the high cervical to mid-thoracic spine. Negative E-FAST and no signs of long bone injuries should raise concern for neurogenic shock in the hypotensive trauma patient with suspected spinal injury. 2011;46(9):1771. J Pediatr Surg.
1-5] Since then, many more medications have been developed and deployed. 1-5] This post focuses on the identification and management of Local Anesthetic Systemic Toxicity (LAST). 3-5,7] Symptom onset is usually within 1 minute of intravascular injection but can be delayed if multiple injections or continuous infusion. [5]
Features Urticaria and pruritis Rapid onset (1-2 hours) IgE Dependent (Type I Hypersensitivity) Reactions An allergen cross-links two or more IgE molecules on mast cells or basophils and initiates a signal cascade leading to degranulation. J Allergy Clin Immune Tract 2017; 5(5): 1402-9. of people who take NSAIDs ( Nzeako 2010 ).
You will find the list is broken down into four sections: 1.Reviews 2024 Apr 9. Associations of excessive internet use, sleep duration and physical activity with school absences: a cross-sectional, population-based study of adolescents in years 8 and 9. 2024 Apr 9:S0890-8567(24)00184-9. 2024 Apr 9.
At about 30 minutes after presentation, the patient had acceptable vital signs with the TVP and low dose epinephrine drip. Another ECG was obtained during pacing: Mostly paced rhythm with PVCs (#3, #6, #9, #12). Figure-1: ECG #1 — recorded by EMS on the scene ( See text ). mm STE with 9.5
When simple maneuvers fail, we proceed to topical agents such as lidocaine with epinephrine, oxymetazoline, anterior nasal packing, and electrical or chemical cauterization. 2013 Sep;31(9):1389-92. Adverse Effects: No serious adverse events were noted. PMID: 33612282 Janapala RN, Tran QK, Patel J, Mehta E, Pourmand A.
Patients were randomized in a 1:1 ratio. T5 (3.9%) patients with adverse events were reported in the IV Cetirizine group compared to 18 (3.9%) in the IV diphenhydramine group. Risk of first-generation H(1)-antihistamines: a GA(2)LEN position paper. 2005 Sep;116(3):643-9. in the IV cetirizine group and 2.1
After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. This CI does include 1; and further and further analysis of the data showed that the likelihood that calcium has a beneficial effect (e.g. References: 1. He is found to be in ventricular fibrillation (VF). Ramazan, K.,
This was based on studies that demonstrated qSOFA was more specific but less sensitive than its counterparts (Table 1). 1 Since 2021, attempts to identify a single screening tool with optimal sensitivity and specificity to predict which patients will develop sepsis or septic shock have been ongoing.
He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Here they are: Learning Points: 1. Type 1 and 2 Myocardial Infarction and Myocardial Injury: Clinical Transition to High-Sensitivity Cardiac Troponin I. Am J Med [Internet] 2017;130(12):1431–9.e4.
As reported within the 6th edition Manual of Emergency Airway Management, there are cardiac arrest rates between 1% and 4%, with other complications (mostly hypoxemia and hypotension) as high as 30% in patients with first-pass success [1, pg 29; 4-10]. Why is Physiologic Optimization Important? Up to 44% per other sources [12].
2020;71(1):235-246. Plt 37×10^9/L and 40×10^9/L, SOC and TEG, respectively) All patients enrolled had an upper endoscopy and verified the source of bleeding. Article: Kumar M et al. Thromboelastography-Guided Blood Component Use in Patients With Cirrhosis With Nonvariceal Bleeding: A Randomized Controlled Trial.
Cardiac Care Show – Episode #1: Mechanical CPR Hello, and welcome to the Cardiac Care Show. One thing we can say unequivocally is that we owe it to our patients to measure outcomes, and to perform post-event reviews of our resuscitation attempts, so that we understand the impact of our interventions. Thanks for joining us.
1 The primary goal of cardiopulmonary resuscitation (CPR) is to optimize coronary perfusion pressure and maintain systemic perfusion in order to prevent neurologic and other end-organ damage while working to achieve ROSC. Kirkegaard H, Soreide E, de Haas, I et al. De Fazio C, Skrifvars MB, Soreide E et al. 2019;23(1):1–9.
She describes the pain as left-sided, non-radiating, and 9/10 in severity. Answer: Takotsubo Cardiomyopathy 1-18 Background: Also known as transient apical ballooning syndrome, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, stress cardiomyopathy, Gebrochenes-Herz syndrome, and broken-heart syndrome.
Resuscitated with chest compressions, epinephrine. Here is the written paramedic report available after all the events were over: Patient was seen by witnesses to become unresponsive. including epinephrine, and there was ROSC. Not a shockable rhythm. They laid her on the floor and called 911.
Episode 116: Massive Hemoptysis Definition: Hemoptysis is expectoration of blood from the respiratory tract; ranges from mild with small streaks of blood to cardiopulmonary compromise (1-5). Massive hemoptysis: no clear definition, ranges from 50 mL in a single expectoration to 100 mL in 24 hours to over 1 L in 48 hours.
EMS found the patient pulseless and apneic, with an initial rhythm showing ventricular fibrillation (see figure 1). He was defibrillated twice and received two doses of epinephrine, with return of spontaneous circulation. Figure 1: The EMS rhythm strip. Type 3 is indicated by J point and ST elevation < 1 mm.
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