Las Vegas EM Conference Pearls: 11/09/16

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.