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TXA (Tranexamic Acid) in Pediatrics 

Pediatric EM Morsels

Kids get hurt. And they get sick. Its inevitable. Whether their fingers get caught accidentally in a car door or bedroom door slamming closed, or they trip and fall while running on their uncooperative little toddler legs , or catching all the germs as their immune systems slowly struggle to fight off every known virus to mankind.

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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].

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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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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! Get a hold of ENT early as OR management and/or admission are common. Set up suction x2 in the room!

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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. Tragically, several attempts at resuscitation upon arrival at the emergency department were unsuccessful. Burgart, A.M.

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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. Moral of the Morsel Anatomy Matters!

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The Modified Valsalva Maneuver: Practical Treatment or Pointless Trick?

REBEL EM

No significant differences in heart rate 1 minute after cardioversion were observed between the three groups. What they did: Prospective randomized controlled trial, unblinded, multicenter study Conducted from January 2017 to December 2022 Patients with confirmed PSVT were randomly assigned to receive MVM, IV Adenosine, or combined therapy.

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