Pediatric airway management is a skill that integrates the three types of knowledge as described by the ancient Greeks:
Episteme — theoretical knowledge
Techne — technical knowledge
Phronesis — practical wisdom — also called prudence.
Here we’ll invoke each type of knowledge and understanding as we go beyond the anatomical issues in pediatric airway management – to the advanced decision-making aspect of RSI and the what-to-do-when the rubber-hits-the road.
Recognizing normal neonatal conditions and behavior
Several agents, both legal and illegal, can cause significantly elevated heart rates. This article reviews the most common causes of drug-induced tachycardia. Diagnosis and management of these conditions are also discussed.
The pediatric and gravid populations have special needs regarding imaging for abdominal pain. This article reviews the more common causes of abdominal pain in children and pregnant women and how to approach imaging in these populations.
The patient with facial pain/injury can present significant challenges for analgesia. Facial nerve blocks present an avenue for great analgesia without compromising wound appearance/repair. What are the pearls and pitfalls for these blocks?
Bacteremia affects 200,000 patients per year, with the potential of causing significant mortality. Blood cultures are considered the most sensitive method for detecting bacteremia and are commonly obtained in patients with fever, chills, leukocytosis, focal infections, sepsis, or suspected endocarditis. However, what is the literature behind obtaining cultures in the ED?
Your overnight junior calls for your help with his decompensating intubated patient. The patient is a 54 year-old male with a history of COPD who was intubated ten minutes ago. The ventilator is alarming due to high pressures. The patient’s current vitals are HR 140, BP 80/50, SpO2 82%. The ventilator settings are VCV rate 12, tidal volume 450, PEEP 15, FiO2 100%. You quickly disconnect the circuit but the patient is not improving. What do you do next?
Vasopressor use in patients with sepsis has been studied extensively, with many calling for early, peripheral vasopressors. What is the literature behind this, and are patient outcomes affected? This post examines the studies for vasopressors in sepsis and more.