Bleeding as a chief complaint in the pediatric emergency department is something that many healthcare providers will come across. Some of these children may have inherited bleeding disorders that we must be aware of in order to provide the best care possible. Below is a basic review of hemophilia and what we should know and do in the emergency department.
Welcome to the inaugural post for an exciting new ultrasound-based case series called “Ultrasound For The Win!” (#US4TW). In this peer-reviewed case series, we will focus on real clinical cases where bedside ultrasound changed the management or aided in the diagnosis. In our first case, we present a 28-year-old female with shortness of breath.
A 64 year old man with an extensive history of abdominal surgeries presents to the emergency department with abdominal pain and vomiting. Because you suspect a bowel obstruction, you bring an ultrasound machine to the bedside prior to the completion of any laboratory testing or other imaging. A curvilinear probe in the abdominal mode setting was used to scan in all four quadrants of the abdomen looking in both the sagittal and transverse planes.
Over the last several years, ALiEM has recruited a team of regular contributors, each with their own individual passions within the entire breadth of Emergency Medicine. ALiEM has provided these individuals with a global platform capable of carrying their message to a target audience of thousands of regular subscribers. Furthermore, the evolution of a rigorous pre-publication Expert Peer Review process has helped ensure that the content is especially polished and scientifically accurate.
Today marks a new day. The overwhelming success of the website and editorial process has led us to what we feel is the next step for this academic blog and online medical education: peer-reviewed community content submission.
Clinical Toxicology has published guidelines for out-of-hospital management of 16 distinct overdoses and their dose thresholds, above which, pediatric patients should be referred to the Emergency Department for evaluation. Clinical Toxicology is the official journal of the American Academy of Clinical Toxicology (AACT, @AACTinfo), the American Association of Poison Control Centers (AAPCC, @AAPCC), and the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT). There are two caveats to be aware of regarding these guidelines.
- They were developed between 2005 and 2007. New medications have been approved since that time and there may be more recent data available.
- As with any poisoning, dose is only one factor when determining disposition. Consideration should also be given to intent, underlying medical conditions, co-ingestion of other medications, presence of symptoms, and drug formulation.
This PV Card summarizes the pediatric ingestion dose thresholds for referral to an ED.
Local anesthetics (LAs) are widely employed to achieve tissue infiltration, peripheral and regional anesthesia, and neuraxial blockades. Despite their well-established toxic dose limits, these agents continue to pose a substantial risk of morbidity and mortality due to local anesthetic toxicity and overdose.