Pediatric EM Morsels

AUGUST 9, 2024

Neonates presenting to the Emergency Department often cause a lot of uncertainty. Let’s review how Congenital Syphilis may present to our Emergency Departments: Congenital Syphilis : Basics Occurs when the spirochete Treponema pallidum is transmitted from mother to fetus. Emerg Radiol. Can identify T.

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E-9-1-1 Plasma Emergency Department OR 152

Don't Forget the Bubbles

JUNE 30, 2023

This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality.

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ACEP Now

APRIL 5, 2024

2 TTP often presents abruptly, and most patients that develop it first visit the emergency department (ED) as their symptoms worsen. It is thus imperative that emergency physicians be able to recognize and properly treat this disease, especially in the absence of its classical presentation. J Emerg Med. Am J Emerg Med.

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Frozen Plasma Plasma Emergency Department FFP 40

FOAMfrat

AUGUST 15, 2024

The midwives report that EMS is not needed for the baby. But, from a basic care perspective, I am not sure there is anything that the average EMS crew would do differently, despite this case being anything but basic. The midwives go on to explain that following the baby’s birth, the patient began to hemorrhage.

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Plasma Ambulance ALS Emergency Department 69

EMDocs

JUNE 7, 2023

8 Plasma butyrylcholinesterase (“pseudocholinesterase”) activity Easier to assay and is more widely available Red cell acetylcholinesterase (“true cholinesterase”) activity More accurate and specific Management: Patients require immediate intervention if there is concern for acute organophosphate poisoning. BMC Res Notes. 2013; 6:524.

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EMDocs

SEPTEMBER 7, 2023

DEG is rapidly absorbed when ingested and can reach peak plasma and brain tissue concentrations within four hours of ingestion. 2 Laboratory assays for DEG are not widely available and have long turn-around-times, thus have limited utility in diagnosis in the emergency department.

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E-9-1-1 ALS Plasma Emergency Department 66

EMDocs

JUNE 14, 2023

Parenteral organophosphorus poisoning in a rural emergency department: a case report. Two assays available used to help confirm diagnosis, however, do not guide treatment Low levels of activity are consistent with organophosphate poisoning. These are send-out labs with turn-around times that make them unlikely to affect the ED course.

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EMDocs

DECEMBER 6, 2024

Antidote : Deferoxamine is a chelating agent derived from Streptomyces pilosus ; binds free iron from plasma and iron inside of cells. Coagulopathy: Parenteral vitamin K and/or fresh frozen plasma (FFP) as clinically indicated. A partner at bedside reports recent depressed mood, abdominal pain, and vomiting yesterday.

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EMDocs

AUGUST 7, 2023

Schnapp, MD, MEd (Associate Program Director, University of Wisconsin) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF), Marina Boushra (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case A 36-year-old pregnant woman at 21 weeks gestation presents to the ED with chest pain. Ann Emerg Med.

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E-9-1-1 ALS Plasma OR 70

ACEP Now

NOVEMBER 16, 2023

Fresh frozen plasma, or FFP, should only be given to cirrhotic patients as part of the massive transfusion protocol in cases of profound hypotension, as “patients with cirrhosis rarely have true enzymatic hypocoagulability, and FFP may worsen bleeding due to over-resuscitation and dilution of coagulation factors.” Acad Emerg Med.

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Frozen Plasma FFP ALS Plasma 52

EMDocs

JUNE 3, 2023

What is the EM physician’s role in the stabilization of unstable pelvic injuries? If a pelvic binder was placed by EMS, inquire whether this was placed empirically or if mechanical pelvic instability was already elicited. Her initial vital signs are blood pressure 76/54 mmHg, heart rate 128 bpm, temperature 37.0˚

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ED Operating Room ALS Frozen Plasma 54

EMDocs

DECEMBER 18, 2023

Today, she would not get out of bed, prompting the facility to call EMS. The first was the suggestion to use balanced crystalloid fluids, such as lactated ringers or plasma-lyte, instead of normal saline. Proadrenomedullin in Sepsis and Septic Shock: A Role in the Emergency Department. She had a fever of 38.7 °C

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E-9-1-1 ALS Emergency Department Plasma 66

EMDocs

MARCH 11, 2024

Authors: Gaston Omba, MD (EM Resident Physician, Makerere University); Jessica Pelletier, DO (EM Education Fellow, Washington University in St. 30 Moreover, OCVs administered to children in endemic regions could provide herd immunity to unvaccinated adults, but the effect in unvaccinated children requires further study.

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FOAMfrat

NOVEMBER 25, 2024

Earlier in the summer, I wrote a blog discussing the challenges, intricacies, and educational pitfalls of postpartum hemorrhage in EMS. For patients suffering from intrapartum cardiac arrest, I would encourage you to transport the patient as expeditiously, but safely, as possible to the closest emergency department.

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