(Click the link to comment and to vote – voting not working through email, sorry!) A multi-casualty incident has occurred, and the emergency department is receiving several patients at once. You are called upon to manage a child of unknown… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) You are told that you will be receiving a 12 month old child in full arrest. CPR is in progress by the paramedics. Your EMS… Continue Reading →
Classic teaching is to estimate the nasopharyngeal airway (NPA) size as the length from the patient’s nares to tragus of the ear, and the oropharyngeal airway (OPA) from the maxillary incisors to the angle of the mandible. However, a few… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 16 year old girl arrives to the ED by ambulance and promptly delivers a 34 weeks by dates neonate. The infant is unresponsive, apneic,… Continue Reading →
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(Click the link to comment and to vote – voting not working through email, sorry!) The pediatric genetics clinic is sending over a patient with respiratory distress. As you prepare for the patient’s arrival, you have a chance to look… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A full term infant born out of asepsis (BOA) at home is brought in by ambulance to your PED. No neonatologist or pediatrician is in… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are sedating a 16 year old boy with past medical history of spontaneously resolved VSD as an infant with ketamine for tube thoracostomy to… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are managing a 1yo patient with submersion injury who has respiratory distress and falling O2 saturation. You begin bag-valve-mask ventilation as you prepare to… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are caring for a 9 year old boy involved in a motor vehicle accident. He has a seatbelt sign on his left neck and… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) A 3 week old infant that is positive for RSV has had several prolonged episodes of apnea requiring BVM ventilation. The decision is made to… Continue Reading →
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From Haliloglu M, Bilgen S, Uzture N, Koner O. Simple method for determining the size of the ProSeal laryngeal mask airway in children: a prospective observational study. Braz J Anesthesiol 2017; 67(1):15-20. The child’s ear is a good estimate of… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) EMS has brought in an 8 month old child who had a generalized tonic-clonic seizure at home. The child has a history of 2 prior… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) For which of the following pediatric patients is it most important to have the clinician with the most experience in advanced airway management and endotracheal… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Which of the following is/are true of bacterial tracheitis? Children presenting with bacterial tracheitis tend to be older than children presenting with viral croup Children… Continue Reading →
The Coach at PEMPlaybook.org has a great podcast on using the VBG in situations where we used to try to get an ABG (which was never fun to do in small children). From the podcast: the rule of 4’s: (note… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) For which of the following patients is a laryngeal mask airway (LMA) as a temporizing measure after failure of intubation contraindicated?
Two tips for intubating the obese patient: Position the patient: build a sizeable ramp to position the patient such that his/her ears are at the level of the sternal notch, and his/her face is parallel to the ceiling Position yourself: keep… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You are caring for a 4 year old child struck by a car. The child has significant maxillofacial trauma, a large parietal hematoma, and a… Continue Reading →
Having trouble with bag valve mask ventilation? Don’t forget to use adjunctive airways – nasopharyngeal for conscious patients, oropharyngeal for unconscious. Reuben Strayer’s great video here advocates placing 2 nasal airways and an oral airway, then bagging over those, for the… Continue Reading →
(Click the link to comment and to vote – voting not working through email, sorry!) You receive word that the clinic is rushing over a patient with a genetic syndrome and respiratory distress. You have a few moments to look… Continue Reading →
You are caring for a 6yo oncology patient presenting in septic shock. Although he is oxygenating and ventilating well at this time, you plan to intubate him to reduce his metabolic work. The most important pre- treatment before rapid sequence… Continue Reading →
Thanks to Tim Horeczko pemplaybook.org for tube-tape-tap mnemonic Link to the latest version
A 36-week infant is born precipitously NSVD to a 17yo G2P1 mother in the ED after the mother presented with the chief complaint of intermittent abdominal pain. Apgars are 8 and 9 at 1 and 5 minutes, with -1 for… Continue Reading →
A 7yo patient with peanut allergy at a rice krispy treat at a birthday party and discovered afterwards that it was made with peanut butter. She presents with hives, mild swelling of her lower lip and periorbital, and some faint… Continue Reading →
A 2 month old ex-30 week premie just discharged from the NICU comes in with respiratory distress and hypoxia. You determine that the patient needs to be intubated. The baby’s weight at discharge was 2.5 kg. What size ETT should… Continue Reading →
Easily remember the approximate Oxygen-Hemoglobin dissociation curve as follows: PaO2 40 corresponds to SaO2 70% PaO2 50 corresponds to SaO2 80% PaO2 60 corresponds to SaO2 90% This rule along with a lot of other handy RT knowledge can be… Continue Reading →
A 17yo boy presents with severe sore throat for two days, and fever to 39. He has difficulty swallowing due to pain. He has no cough, congestion, nor ill contacts. His immunizations are up to date. On examination, he is… Continue Reading →
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