Alison Jaworski, MD
Consider a case: a 38 year-old male presents to the ED after intentional ingesion of multiple objects, which include razor blades, a fork and other sharp objects. Vital signs are stable, he has no abdominal tenderness, and an x-ray reveals several foreign bodies in the stomach that appear consistent with sharp objects, with no free air under the diaphragm. How do you approach this scenario and other similar cases?
A full discusison of pediatric burns would involve management of ABCs, calculation of body surface area burned and the intricacies of different calculations, fluid management, pain control, and finally disposition. For this, read a full chapter and several articles on burn management and resuscitation - here we have a quick rundown of what patients require transfer to burn center and/or admission vs which might be able to be discharged home.
Last week, we briefly defined hypertensive emergency as acute blood pressure elevation (SBP >180 and/or DBP>120) with evidence of end-organ damage. (Remember, hypertensive urgency is the same blood pressure elevation without end-organ damage). Once we have identified a hypertensive emergency, what are our best treatment options? Below is a quick guide (not comprehensive) to some go-to options.
Acute urinary retention + contraindication/failure of foley catheter? Suprapubic catheters (or suprapubic aspiration) are rarely done in the ED but are an important procedure to know for the few times when no other option will suffice!