Introducing Paediatric ECG Central

Cite this article as: Davis, T. Introducing Paediatric ECG Central, Don't Forget the Bubbles, 2014. Available at: http://doi.org/10.31440/DFTB.5863The lovely people at the Princess Margaret Hospital for Children in Perth have given us permission to publish the (hot off the press) updated version of their Paediatric ECG Guidance. ECG Central will be a great resource to have…

Bleeding lips and cardiac arrest

Cite this article as: Yamamoto, L. Bleeding lips and cardiac arrest, Don't Forget the Bubbles, 2013. Available at: https://dontforgetthebubbles.com/bleeding-lips-and-cardiac-arrest/This is a 2 1/2 month old male who presented to the ED with a 2 week history of intermittent low grade fevers. He was seen by his primary physician 2 weeks prior to this ED visit…

Congenital heart disease in PEM

Cite this article as: Davis, T. Congenital heart disease in PEM, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.4454Cyanotic heart disease in acute paeds is a nightmare. How much oxygen to give? How much fluid to give? How quickly can google explain a Stage II Fontan?

Inotropes and vasodilators

Cite this article as: Anders, M. Inotropes and vasodilators, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3934Vasodilators: Decreasing the pressures against which the heart works (systemic and pulmonary afterload); decreasing the work of the heart hence myocardial O2 demand. Usual indications for vasodilator therapy are: systemic vasodilation (LV afterload reduction), pulmonary vasodilatation (RV afterload reduction),…

Haemofiltration and dialysis

Cite this article as: Anders, M. Haemofiltration and dialysis, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3735Indications: Correction of water overload To remove larger quantities of water from the body than the kidney is able to achieve in order to enable the administration of therapeutic fluids such as parenteral nutrition To remove excess electrolytes Correction…

Renal Failure

Cite this article as: Anders, M. Renal Failure, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3719Definition: acute kidney injury (AKI) is failure of the kidneys to regulate electrolyte, acid-base and fluid homeostasis adequately with concomitant reduction in glomerular filtration rate (GFR). pRIFLE (paediatric Risk, Injury, Failure, Loss, End-Stage Criteria). Chronic renal failure: hyperfiltration, estimated creatinine clearance <75 ml/min/1.73m2 , hypertension,…

Prolonged QT syndrome

Cite this article as: Anders, M. Prolonged QT syndrome, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3681Definition: prolonged QTc interval, calculated by Bazett’s formula: QTc = QT : sqr (previous RR interval). normal <440 ms (460 ms in women and children).

Open chest

Cite this article as: Anders, M. Open chest, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3705Negative impact on haemodynamics and respiratory parameters after median sternotomy was first described in 1975, with emphasis on “compression of the heart and producing a cardiac tamponade”. Indications for delayed sterna closure and open chest: ‘Large’ heart syndrome Haemodynamic instability…

Fluids

Cite this article as: Anders, M. Fluids, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3689Anion gap = Na+ + K+ – (Cl– + HCO3–). normal 8-12 mEq/l. Total body water (TBW) = intracellular fluid (ICF) plus extracellular fluid (ECF). [Weight x 600 ml in adults (500 ml in female), Weight x 650 ml in paeds, Weight x 700 ml in…

Chest drains

Cite this article as: Anders, M. Chest drains, Don't Forget the Bubbles, 2013. Available at: http://doi.org/10.31440/DFTB.3699If losses >10 ml/kg/hr in a postoperative patient, notify surgeon immediately. In the first two hours, losses may be up to 5 ml/kg/hr, thereafter it should be less than 2 ml/kg/hr. If losses exceeds these levels, check ACT, aPTT, PT,…