- Early recognition and treatment is critical.... give epinephrine EARLY and OFTEN
- Treat anaphylaxis as a spectrum... as short as 2 hour observation up to admission
- Steroid duration depends on who you ask. No good evidence to support or refute their use.
- Vasopression for anaphylatic shock with suboptimal epi response.
- Consider glucagon for those patients on beta-blockers.
Pediatric Disaster Medicine and Triage - Noste
Myth 4 - The extent of surface burn determines the extent of the injury. Unfortunately, skin findings can be misleading.
Myth 5 - The pathway the electricity takes through the body predicts the pattern of injury. It is helpful to be able to see evidence of the path that the electricity took (ex, from toe to hand), but once again, this can be misleading.
Myth 6 - All patients with electric injuries require 24 hours of cardiac monitoring. Most patients who arrive to the ED without having had an arrhythmia and who have a normal ECG with no symptoms do not require prolonged monitoring.
Myth 7 - Cardiac monitoring and further testing is always required for TASER injuries. There have been deaths noted with TASER injuries, but these have all been associated with patients who had "excited delirium" -- PCP and TASER is a bad combination.
Myth 8 - Victims of lightning injury should not undergo prolonged resuscitation. Lightning victims can have meaningful recoveries after prolonged resuscitation. They can even present with Fixed and Dilated pupils. Do not tell EMS providers to pronounce the victim in the field. Continue to resuscitate and bring them to the ED to further assess.
High Altitude Cerebral Edema (HACE)
High Altitude Pulmonary Edema (HAPE)
Some Pain Control Options
WE can use ketamine here for pain control...talk to the nurses before you order it though... it might be misunderstood.
Crotalid Envenomations Dr. Beuhler
Important steps in management of bite care:
Don't just treat lab abnormalities
a. Crofab = 10cc/hr; 4 vials & reevaluate after 1-2 hrs.
Remember crofab interrupts coagulopathy & helps lower compartment pressures & possibly helps with pain - it will NOT stop or reverse local tissue destruction
If you DC home have follow up in < 24 hrs for wound reevaluation