![]() Trauma Resuscitation: Not ACLS
It's Not Always Sepsis!
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![]() #1. FUO is most commonly: 1) infection, 2) collagen vascular disorder, and 3) neoplasm #2. Always consider uncommon presentations of common diagnoses #3. Repeating the clinical exam is key a) think about the child that has returned to the CED for the 3rd time in as many weeks... the new findings on your exam may be what leads to the final diagnosis #4. No clear-cut rules for home vs. admit, but consider age, follow-up, and clinical severity See Ped EM Morsel - http://pedemmorsels.com/fever-of-unknown-origin/ ![]() 1. Never get involved in a land war in Asia. 2. Never go in against a Sicilian when death is on the line. 3. Headache with an abnormal neuro exam is always worrisome... and always look at there fundus. 4. Avoid diagnostic momentum - just because it sounds like gastroenteritis doesn't mean it is. 5. If a child has conjunctivits, always look at the ears and consider treatment should include oral antibiotics covering beta-lactam producers. ![]() What is STEMI without STE?
Posterolateral or High Posterior MI
High Lateral MI
RV infarct
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![]() 1. Remember esophageal etiologies as a cause of life threatening chest pain. 2. Esophageal perforation is rare, deadly, and fast acting. Delay in diagnosis can cause doubling of mortality. 3. Know best imagning studies available at facility, and have low threshold for surgical consultation. 4. Quick recognization and initation of medical management is key: NPO, PPI, and antibiotics (ie zosyn) in all cases. 5. Be familiar with the latest management of esophageal perforation: medical management vs surgical management vs stent placement. ![]() Septic arthritis of the hip -Most common hematongenous spread - Up to 20% of patients with non-gonococcal septic arthritis will have 2 or more joints involved –> always do a full musculoskeletal exam! - 50% will have positive blood cultures –> always obtain cultures. - Risk factors: Extremes of age, hardware/recent instrumentation, skin infection, underlying arthritis, IV drug use - You cannot rule out septic arthritis with inflammatory markers or any physical exam findings, so err on the side of obtaining joint fluid. Pediatric septic arthritis vs. transient synovitis - Kocher criteria can help differentiate: Temperature >38.5, WBC >12K, ESR >40, unable to bear weight.
Contrast Extravasation
Spontaneous Pneumomediastnum
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