- Maternal well-being = fetal well-being… resuscitation the mother!!!
- Understand important changes in maternal physiology:
- Increased blood volume
- Decreased respiratory reserve
- Aggressive early management of the ABCs essential
- Thoughtful diagnostic testing that still protects mother and baby
- Placental abruption a risk following both major and minor trauma
Prehospital Provider Medicolegal Risks
EMTALA with respect to EMS
Air Medical Transport
Multiple factors related to air vs. ground transport:
1. Every fever does not require a urine screening test.
2. UTI= pyuria plus >50,000 CFU single organism
3. UTI becomes the diagnosis when the culture is available. We start antibiotics based on the results of the screening UA. Follow up is needed.
4. Choose antibiotics by resistance patterns and not your favorite PEM attending.
5. Renal scars are a long term consequence of pyelonephritis. Whether we can prevent scarring remains uncertain.
1) Three main skin cancers: Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma.
2) Basal cell carcinoma is the most common type at 70-80% of skin cancers.
3) Skin cancers cause emergencies of the airway with obstruction, GI tract with obstruction and perforation, bleeding with carotid blowout syndrome, and pain with bony, nerve, and soft tissue metastases.
4) If you're not a dermatology wizard, use VisualDx to aide you and refer them to a dermatologist.
1. Intussusception is the most common cause intestinal obstruction in infants between 6 and 36 months of age.
2. It usually presents with intermittent abdominal pain and sometimes vomiting, however lethargy or altered mental status can be the initial presenting sign.
3. In any infant or child presenting with altered mental status, think of intussusception as possible etiology.
4. In stable patient with no signs of perforation who has signs of intussusception, nonoperative reduction is recommended.
5. Surgical treatment is the primary intervention for patients who are unstable or have evidence of perforation.