By Gary R. Strange, William F. Ahrens, Steven Lelyveld, Robert W. Schafermeyer
ISBN-10: 0071380752
ISBN-13: 9780071380751
Subsidized through the yankee collage of Emergency Physicians and written by way of a popular staff of pediatric emergency physicians, this groundbreaking ebook bargains a finished assessment of the full-spectrum of pediatric emergencies. Concise, clinically centred and instantly obtainable, it's the most sensible to be had software for successfully comparing and treating a wide-range of court cases mostly encountered in an emergency environment. positive factors new to this e-book: bulleted checklist of high-yield proof first and foremost of every bankruptcy; elevated insurance of cardiac care; and key tables, diagrams, and equations now at the within covers for convenient reference.
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Backed through the yankee collage of Emergency Physicians and written by means of a well known group of pediatric emergency physicians, this groundbreaking e-book bargains a entire overview of the full-spectrum of pediatric emergencies. Concise, clinically targeted and instantly available, it's the most sensible to be had instrument for successfully comparing and treating a wide-range of lawsuits typically encountered in an emergency environment.
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Sample text
Vigorous drying is often sufficient. More aggressive methods of stimulation include rubbing the infant’s back and slapping the soles of its feet. Thermoregulation The newborn is at great risk for hypothermia as amniotic fluid evaporates. Hypothermia results is increased oxygen consumption, hypoglycemia, and, if severe, respiratory and metabolic acidosis. Premature and asphyxiated newborns are especially vulnerable to the deleterious effects of hypothermia. Heat loss is prevented by placing the infant under a radiant warmer and quickly drying off the amniotic fluid.
Assessment 3 SHOCK 13 of the adequacy of the airway and ventilation is performed while administering 100% oxygen. Intubation and assisted ventilation is indicated in cases of fulminant shock and when acidosis is not immediately corrected with volume resuscitation. This is particularly important in managing septic and cardiogenic shock. Early intubation will protect the airway, and ventilatory support will remove the work of breathing and improve metabolic balance. After establishment of oxygenation and ventilation, treatment includes rapid fluid replacement to establish effective intravascular volume.
Both volume and pressure ventilators have the ability to provide positive end-expiratory pressure (PEEP), which is especially important in situations in which there is decreased lung compliance. 3 SHOCK 9 The major side effect of excessive PEEP is decreased venous return to the right side of the heart and decreased cardiac output. In the emergency department setting, PEEP is usually set at 3 to 5 cmH2O. For a more detailed discussion, see Cowan M, Abramo T: Respiratory failure, chap. 2, p. 4, in Pediatric Emergency Medicine: A Comprehensive Study Guide.
Pediatric Emergency Medicine by Gary R. Strange, William F. Ahrens, Steven Lelyveld, Robert W. Schafermeyer
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