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TXA (Tranexamic Acid) in Pediatrics 

Pediatric EM Morsels

Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H,Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA,Meja-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR,Yutthakasemsunt S. 2012 Feb;147(2):113-9. 2020;2(1):e0075.

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emDOCs Podcast – Episode 110: Primary Spontaneous Bacterial Peritonitis

EMDocs

Commonly a monomicrobial infection with gram-negative bacteria like E. Paracentesis is a safe procedure with a low complication rate (< 1%). For the remaining fluid inject 1 mL into a purple top EDTA blood tube for cell count; send 2-3 mL for Gram stain in a red-top tube or sterile urine container. coli (50-90% of cases).

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Tranq dope (fentanyl-xylazine combination): A new horizon in opioid withdrawal treatment

ALiEM

Due in large part to the proliferation of anonymous chemical factories able to produce industrial volumes of inexpensive synthetic opioids without opium or other controlled precursors, fentanyl spilled into the United States, Canada, and Europe, heroin soon fell to market forces [1, 2]. Xylazine withdrawal is controversial.

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Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Pediatric EM Morsels

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.

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Awake, and Paralysed: A Never Event

Don't Forget the Bubbles

Intubated, awake, and paralysed: a never event. Intensive Care Research , 1 (3-4), pp.60-64. A never event Never events are usually preventable serious adverse events which should be reported. This paralysis-only intubation meets the criteria for a never event. Epub 2014 Sep 9. 2013 Jan;31(1):222-6.

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Neurogenic Shock in Children

Pediatric EM Morsels

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.

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Trauma Resuscitation Updates

REBEL EM

mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al. mental status, urine output, capillary refill) is more important than an actual goal PERMISSIVE HYPOTENSTION IN PTS WITH TBI Brotfain E et al.

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