Randoms / Emails good to know

What are things in the crash cart?

First drawer
Medication tray & volume

Second drawer
IV supplies

Third drawer
Airway supplies

Fourth drawer
UVC & defibrillation supplies

In a stable PDA - what would you be asessing?

Management includes:

• Monitoring respiratory status, oxygen requirements, and perfusion.

• Monitoring urine output and fluid balance.

• Individualized fluid management (fluid restriction does not necessarily promote PDA closure and may compromise systemic blood flow).

• Serial echos to assess PDA significance and potential spontaneous closure.

what are some Clinical findings that may suggest a significant PDA ?

Clinical findings that may suggest a significant PDA include:

• Systolic murmur and/or overactive precordium.

• Bounding pulses and widened pulse pressure (greater than 25 mmHg).

• Increasing respiratory support or difficulty weaning ventilation.

• Pulmonary hemorrhage.

• Hypotension, metabolic acidosis, or decreased urine output (signs of systemic hypoperfusion).

What needs what filter?

What else should be considered when a kid is presented with hypospadias?

What else is considered or investigated?

Depending on the severity of the hypospadias will lead to other investigations.

1. Undescended testes – 8-10% of males with hypospadias also have undescended (American association of Urology care foundation) testicles

2. Disorders of sex development (DSD) - if a baby has hypospadias as well as undescended testis, there may be a high suspicion of for DSD or ambiguous genitalia 

-imaging may be required of urinary and Reproductive tract

3. Genetics and Endocrine testing

-karyotype; to evaluate chromosomes and confirm genetic sex

- hormone panels; to rule out metabolic or endocrine conditions such as Congenial Adrenal Hyperplasia (CAH) or problems with testosterone production