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F.O.A.M. BLOG

Las Vegas FOAM Blog is dedicated to sharing cutting edge learning with anyone, anywhere, anytime.  We hope to inspire discussion, challenge dogma, and keep readers up to date on the latest in emergency medicine. This site is managed by the residents of Las Vegas’ Emergency Medicine Residency program and we are committed to promoting the FOAMed movement.

Las Vegas EM Conference Pearls: 11/09/16

11/9/2016

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By Emerson Posadas MD PGY-1
Abdominal Aortic Aneurysm:  Dr. Chris Pitotti
1. Men are at greater risk of AAA than women. 
2. Hypotension is the least consistent presentation within the pain-hypotension-pulsatile mass triad.
3. Permissive hypotension is the rule. Do not over resuscitate.
Pediatric Hyponatremia: Dr. Iggie Tanone
1. No greater than 8mmol/L Na correction within a 24 hour period. Q2 hour rechecks of sodium level during resuscitation.
2. If seizing, give 3% hypertonic saline, 4ml/kg, over 10-15 minutes 
Pediatric Hypoglycemia: Dr. Iggie Tanone
Rule of 50 for hypoglycemia correction (Dextrose concentration x dose/kg = 50): 
If using D10 then dose at 5ml/kg 
If using D25 then dose at 2ml/kg 
Do not give D50 because it can cause sclerosing of veins. in pediatric age range.
Pacemaker/AICD Management: Dr. Brian Delmonaco
1. Right ventricular pacing mimics left bundle branch block. Use Modified Sgarbossa criteria to interpret STI in a paced EKG.
2. In pacemaker-mediated tachycardia, placing a magnet over the pacemaker puts it in asynchronous mode.
3. Who needs emergent evaluation and interrogation? – Patients who experience a single shock with cardiac symptoms or multiple shocks.

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