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EM Clerkship

Peds H- Hyperglycemia and Hypoglycemia

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5795 Ratings

🗓️ 21 January 2018

⏱️ 8 minutes

🧾️ Download transcript

Summary

Introduction In pediatric patients, have a low threshold to check blood sugar Undiagnosed diabetics commonly identified in ED during first episode of DKA HYPOglycemia is very common in multiple conditions, especially in ill children Hyperglycemia DKA is different in kids They get cerebral edema Increased intracranial pressure with rapid fluid administration Common symptoms Headache Altered […]

Transcript

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0:00.0

Hello, med students. My name is Zach Olson and thank you for downloading this week's episode of the EM Clerkship Podcast.

0:14.0

Okay, everybody, this is Dakota. He's a three and a half year old male. He's awoken with diffuse abdominal pain.

0:21.6

According to mom, he vominated about five times. Some of that was productive.

0:25.6

Has a rash on the anterior chest. He was lethargic when we got there since we've been there with him and through the transport.

0:32.6

Now crying, as you can see. Lone sounds were clear as far as we can tell we then

0:38.7

noticed so two sats dropping and had cyanosis around the lips so he put him on

0:42.2

02 he's one he had no previous fever now 102.3 rectal mom and extended family

0:50.0

are out here so just FYI GCS at 10 BP 100 over 60

0:54.2

Pulse of 1 2097% on the O2 and no allergies no meds had not been sick for the past couple days

1:01.1

any questions anybody I know it's a lot he's kind of crunking on us okay thank you all right All right, same case.

1:15.7

I'm trying to mentally prepare you for this type of thing.

1:18.7

That's why we keep repeating this.

1:21.1

Sick babies and sick kids are scary.

1:25.7

And we are currently in the middle of our series on our sick pediatric patient

1:30.0

mnemonic, oh shit, grab the brazla, which is the mnemonic you whip out anytime you have

1:36.4

a peds patient that doesn't look well and makes you nervous. And this is opposed to the vast

1:43.1

majority of pediatric cases where the kid looks great.

1:46.2

The demonic stands for start oxygen and consider your airway and breathing disorders.

1:53.3

And H this week stands for hyper and hypoglycemia. Check that finger stick glucose.

2:03.8

And then in the following weeks, we'll do S for sepsis,

2:11.1

H for heart, I for inborn errors of metabolism and endocrinology, and T for tummy and trauma.

2:20.2

Super high-yield stuff. Whenever we see these sick kids, we grab a Roslo tape and get to work on this algorithm.

...

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