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Subcutaneous Insulin for DKA

In the U.S. most DKA is managed in the ED with IV insulin drips, but short acting subcutaneous regimens can be just as effective. The subcutaneous regimen should utilize asparte not regular insulin and requires dosing at 1hr or 2 hour intervals depending on the chosen protocol.  The subQ regimen is more utilized in Europe but is worth discussing with your pharmacist in order to have an alternative means of managing a...

The Complexities of RSI

Mastery of RSI is important for both procedural success and quality care.  In children, the many nuances of RSI drug dosing, routes and medications become even more apparent.

  • Should you use etomidate or ketamine?
  • Succinylcholine or Rocuronium?
  • Considerations for Trauma
  • Vasopressor use during RSI

Bleeding and Anemia in a Jehovah’s Witness

The bleeding Jehovah’s Witness patient presents a serious problem, especially if actively bleeding.  For the acute traumatic bleeding, early hemorrhage control and autotransfusion are the only options.  For severely anemic patients erythropoietin stimulation, aggressive iron and vitamin administration are the safest most widely accepted methods.… Read more