Ped EM M&M - Dr. Pinzon
-- Limitations - requires patient cooperation, not definitive airway.
-- Intubate when the above doesn't work - but increased morbidity and mortality with intubation
- Respiratory rate
- Short inspiratory time
- I:E ratio 1:3 to 1:5
Delayed sequence intubation
10 day old with vomiting
- Hx of "GERD" since day of life 4; Mom GBS + but treated and baby full term without complications; +constipation
- Green emesis day of presentation - looks great at bedside
- Neonate with Bilious Emesis - KEEP IT SIMPLE... Neonate with Bilious Emesis = Badness until proven otherwise.
-- Surgical vs non surgical - Surgical includes duodenal atresia, malrotation with volvulus, NEC. Also consider Sepsis.
- arrest of normal rotation of embryonic gut > usually presents in infancy
-- >50% of kids will present before one month of age
-- >90% have vomiting - it won't always be bilious
-- > Urgent surgical consultation if kid looks bad
-- Plain films - not sensitive or sepcific
- May see double bubble sign
-- Upper GI = study of choice
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