EMRAP and AIR (Pediatric Peripheral IV and Splinting) (October 2020)

in Asynchronous Learning
October 6th, 2020

AIR: https://aliemu.com/courses/point-of-care-ultrasound-pediatric-peripheral-iv/

https://aliemu.com/courses/approach-to-splinting/

EM:RAP for Asynchronous Learning! For credit, first, listen to the entire podcast. Your participation in the discussion board here is your attestation that you have listened and engaged with the content in a meaningful way.

https://www.emrap.org/episode/emrap202012/october

When you have finished listening to the podcast, answer the following questions:

1. Please list three things you learned from this podcast that you were not aware of before.
2. Are there any areas of your practice that you would change after listening to this podcast? If so, what would you do differently?
3. What topic mentioned in this podcast is considered too “bleeding edge” (ex. too new, lacks enough evidence, not ready for prime time). Are there any practices mentioned in this podcast that you would consider to not be applicable to our practice setting here at BMC?

One Comment on EMRAP and AIR (Pediatric Peripheral IV and Splinting) (October 2020)

  • Not aware before:
    1. I was aware of the fact that hypertriglyceridemia was a relatively common cause of pancreatitis, however I was not aware of the utility of insulin infusion for acutely lowering triglyceride levels in the ED as that is a much easier intervention than plasmapheresis. In fact, after hearing this information I had a patient with this same presentation and started him on an insulin infusion.
    2. I was not aware of the concern for increased ICP as a cause of encephalopathy in acute liver failure patients and to evaluate this with either a head CT or optic sheath US. I would have probably otherwise just attributed this encephalopathy to hepatic encephalopathy.
    3. I was unaware of how to w/up pregnant patients with stroke and it is reassuring that you can also start with CT/CTA and that this imaging is of relatively low risk to the fetus. Also good to know that TPA does not cross the placenta.
    Practice Change:
    Given the significantly increased risk that asplenic patients have for severe infections I plan to screen more patients for asplenic status in order to better risk stratify which ones with infections can go home vs need to stay in the hospital.
    “Bleeding Edge”
    The new data regarding the TMACS and EDACS scores for low risk chest pain are very exciting and incorporating them may allow us to discharge a higher percentage of low risk chest pain patients. However, these scores have not yet been validated in our department and as such the HEART score will remain the standard of care. I look forward to hopefully incorporating these more in the future!

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