While often alarming, neonatal resuscitation is critical in the care of a neonate. In the critical care transport environment preparations is crucial in optimizing resuscitation success. In this edition of Air Care Series, Dr. Irankunda walks us through neonatal resuscitation in the transport environment.Read More
This week we were led through the evaluation and management of the difficult pediatric airway with Dr. Carleton in our quarterly airway grand rounds, and discussed cranial nerve abnormalities with Dr. Neel in our recurring EM-neuro combined conference. Dr. Jarrell presented an interesting case of a child with a cough and weight loss, and Dr. Jensen walked us through the clinical utility of BNP. Finally, Dr. Miller presented an interesting case of a patient with multisystem organ failure and cecum perforation.Read More
This week Dr. Carleton kicked off a lecture series on the pediatric airway by discussing some anatomic and physiologic challenges as well as predictors of difficulty. In the latest installment of our Global Health lecture series, Dr. Lagasse gave us a great review on the unique uses of point of care ultrasound in a resource limited setting. Our R1 Diagnostics curriculum was continue by Dr. Gleimer who discussed the use of PFTs in the ED setting and Drs. Ham & Wright finished things up with an altered mental status CPC presentation.Read More
You are sitting on the helipad during your UH shift talking with the flight nurse when the tones drop for a pediatric scene call. You gather yourself after you have that crap your pants moment that everyone has with pediatric scene calls and whip out your smart phone with your pediatric application of choice. You begin to write down doses and sizes on your tape on your leg based on the report of the patient’s weight from the providers on scene.
You land in an elementary school parking lot to the delight of the children at the local school. Cars begin to slow and pull over as you exit the helicopter and walk to the squad. You walk to the side door of the ambulance and find 6 EMTs crammed in the squad.Read More
Pressor Primer with Dr. Hebbeler-Clark
- Norepinephrine seems to be on top in terms of vasopressor of choice currently (consider it your "easy button")
- Per Surviving Sepsis Guidelines, Norepi has level 1B evidence as a first line pressor, while Epi is your second line with level 2B evidence and Vasopressin is currently ungraded in terms of evidence level
- There have been 4 RCT's confirming that Norepi has no mortality difference from Epi and given it's safer side effect profile, use it regularly
Mortality & Morbidity Conference with Dr. Bohanske
When volumes are high, remember the patient experience can be improved by acknowledging wait times when entering the room and apologizing for their wait.
Transverse myelitis is a result of partial inflammation of the spinal cord that can sometimes lead to necrosis.
- The disease process is often progressive and function does not always return after treatment.
- Most commonly this is idiopathic in nature but it is often attributed to a post-infectious inflammatory state.
- Differential diagnosis should always include cord ischemia versus compression, and diagnosis hinges on a T2-weighted MRI.