Welcome

I struggled to find PEM resources for my CT3 year, despite the variety of excellent resources out there. I hope this website will help point you in the right direction. I'm not a PEM expert, but am following the guidance CEM have issued (in the form of a syllabus) to put together this page. This page is not endorsed by CEM, and any mistakes are mine.

Please comment with corrections, additions and further suggestions.

All the information here is collected from the internet, and it might be out of date or inaccurate, so please use your judgement and adhere to your hospital's protocols. If you do notice any errors or omissions please comment so we can put them right!

To navigate, decide whether you want to start with a PMP or a PAP. You can then select which PMP or PAP you want to look at. You will then be taken to the summary page for that PMP, with links expanded topic collections. If you know what topic you want to look at already, click on the link on the right hand side.

Thursday, 27 October 2016

Collapsed Neonates

Resuscitate
As per appropriate
Adrenaline 10mcg/kg

Prostin -  
    - 5 ng/kg/min if clinically well
    - 20 ng/kg/min if unstable or absent femoral pulses
    - 50-100 ng/kg/min if no response
Apnoea common: 1st hr of Rx, dose
Hypotension may occur with high dose

Prostin
- 5 ng/kg/min if clinically well
- 20 ng/kg/min if unstable or absent femoral pulses
- 50-100 ng/kg/min if no response
Apnoea common: 1st hr of Rx, dose

Hypotension may occur with high dose

Think about Causes
Infection
Group B strep, E Coli - PROM, maternal GBS, fever in labour
Herpes Simplex - GCS, coagulopathy, ALT, family cold sores
MRSA - Unresponsive 1st line antibiotics,+ contact

Cardiac
Coarctation aorta - Systolic arm/leg gradient > 20 mmHg
Hypoplastic Left heart - Poor pulses –may be pink= pulm. overcirculation
Transposition (TGA) - Preductal sats < post ductal sats
TAPVD (obstructed) - Shocked & cyanosed/CXR plethoric
SVT  - HR>220 despite fluid, f ixed HR, narrow QRS
Myocarditis - Cardiac failure, tachycardia, small QRS

Injury 
Intracranial bleed  - Focal neuro signs, fontanel le , retinal bleeds
Intrabdominal bleed - Unexplained anaemia, abdominal bruising

Cardiac

Metabolic
Vomiting, reduced GCS, hypoglycaemia
Stop the feeds. Give fluid and dextrose as highly likely to be fluid depleted

References
http://paediatricem.blogspot.co.uk/search/label/NLS
http://www.rcemlearning.co.uk/references/congenital-heart-disease/ 
http://www.rcemlearning.co.uk/modules/the-shocked-neonate/ 
http://www.rcemfoamed.co.uk/portfolio/metabolic-babies-in-the-ed-easy-as-1-2-3/ 

1 comment:

  1. Don’t think of anything else just contact Dr Abalaka and purchase some of his herbal medication and your depression will go away. This was my state of mind when my doctor told me that i will not be able to conceive due to the Fibroid that was rolling in my family life and when i decide to reach out to the priest, and the Priest told me what to do in other to get the medication. Eventually I receive all the Herbal medications that cure my Fibroid and give me the chance to become a proud mother: Dr Abalaka is a great spiritualist, He did it for me, you can contact Dr on (dr.abalaka@outlook.com). If you are suffering from the following gynecology disease::
    Fibroid
    High Blood Pressure (herbs to reduce your BP within 7days)
    Diabetes
    Infection, regular body pains
    Blockage from the fallopian Tube
    Cyst from the ovaries
    Unpleasant smell from the virginal
    Irregular menstruation
    Weakness of the penis (not able to have sex with your partner or inability to satisfy your partner sexually)
    Watering sperm (low sperm count) not able to get woman pregnant.
    Infertility for easy Conception.......
    Erectile dysfunction treatment
    Skin diseases, Toilet infection and bad body odor…….Etc..
    Get your ex back
    Happiness in relationship
    Command respect in the society
    Enlarge your Penis/breast with no side effect
    Impotent solution
    Obesity solution
    Romanticism solutions
    Cancer of the blood
    Sickle cell
    Epilepsy
    Lupus disease
    Insomnia
    Parkinson disease
    General consultation
    Those are the things he does, You can simply contact the spiritualist Dr Abalaka on (dr.abalaka@outlook.com) to get his Herbal Medication to cure your disease and put yourself on a motherhood side of life..

    ReplyDelete