What Defines Pediatric Hypotension?

What Defines Pediatric Hypotension?

The Pediatric Advanced Life Support (PALS)/Advanced Trauma Life Support (ATLS) formula to define hypotension in children (i.e. 5th percentile SBP) seems to be a good compromise between German and U.S. population norms for children. The formula is: Low SBP = <70 + 2(age in years).

Advanced Airway for Pediatric Cardiac Arrest - Should We Just Bag?

Advanced Airway for Pediatric Cardiac Arrest - Should We Just Bag?

There may be a slight advantage for pediatric cardiac arrest patients in survival with good neurological outcome by using simple bag-valve mask ventilation over advanced airway management.

ANDROMEDA-SHOCK - Capillary Refill vs. Lactate

ANDROMEDA-SHOCK - Capillary Refill vs. Lactate

Peripheral perfusion guided resuscitation was better than lactate clearance in patients with septic shock in regard to improving organ dysfunction at 72 hours (SOFA score) and barely missed statistical significance in reducing 28-day mortality.

Multiplex PCR in Critically Ill Hematology Patients

Multiplex PCR in Critically Ill Hematology Patients

Presence of any virus on multiplex PCR (particularly influenza, parainfluenza, and RSV) in critically ill hematology patients was associated with an increased risk for respiratory failure and ICU mortality.

Is This Patient Really Penicillin Allergic?

Is This Patient Really Penicillin Allergic?

Penicillin allergy is a lot less common than patients report. A low-risk history could allow you to prescribe it in the ED or clinic.

Pediatric Needle Decompression - What Size Needle?

Pediatric Needle Decompression - What Size Needle?

A standard 5cm 14-16 gauge needle for chest decompression was more than twice as long as needed for children < 13 years old based on CT chest wall thickness (CWT).

Succinylcholine or Rocuronium - Which Is Better?

Succinylcholine or Rocuronium - Which Is Better?

A large observational series with over 4,000 intubations compared succinylcholine vs. rocuronium in rapid sequence intubation and found no association between these two paralytics and first-pass intubation success or peri-intubation adverse effects.

PROTRACH - HFNC for Preoxygenation in the ICU

PROTRACH - HFNC for Preoxygenation in the ICU

High-flow nasal cannula (HFNC) compared to bag-valve mask (BVM) ventilation for preoxygenation of critically ill patients did not improve lowest SpO2 but significantly reduced severe complications (SpO2 < 80%, severe hypotension, and cardiac arrest); 6% HFNC vs. 16% BVM, NNT = 10.

Nerve Agent Incidents and Public Health Preparedness

Nerve Agent Incidents and Public Health Preparedness

Management of nerve agent (NA) poisoning requires recognition of the syndrome and availability of the antidote. It is important to remember that besides the classic “SLUDGE” and “Killer B’s,” there is also the nicotinic syndrome which can cloud the clinical presentation. Add the “weekdays” mnemonic for nicotinic effects to your list of symptoms in NA toxicity.

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