Clinical Tips

Permissive hypertension applies when ALL 3 criteria are met: 1. Patient NOT receiving reperfusion no tPA, no EVT 2. BP

NIHSS 12. tPA only no EVT. BP trending up: 162 → 168/98. Target should be 130-140. You notice subtle drowsiness. STAT

BP variability is an independent predictor of poor outcomes: • ↑10mmHg SBP variability → 14% less chance of favorable o

F — Fatal: Use ABC — Volvulus neonate, Intussusception infant, Appendicitis child >5 A — Assess: Age = first diagnostic

A = 0-1 month → Volvulus Red flag: Bilious green/yellow vomiting → Emergent upper GI series B = 2 months - 2 years → I

Green or yellow vomiting in a baby <1 month is NEVER reflux. NEVER formula intolerance. It is malrotation with volvulu

No crying. No leg-drawing. Just a sleepy baby. Don't wait for the classic triad. Lethargy alone in an infant with ANY

Reality: Well appearance between episodes IS the pattern of intussusception Children with intussusception can seem pe

Episodes of crying, drawing up legs. Drowsy between episodes. Refused his bottle. No fever. No diarrhea. Triage note s

Testicular torsion presents as REFERRED abdominal pain. The child complains of belly pain while the testicle is dying.

Reality: 3 clinical trials confirm analgesia does NOT mask surgical diagnosis Evidence Kim, Green, Bailey trials: • D

F — Fatal: Sepsis kills 350,000+ Americans/year — most saw a provider before crashing A — Assess: RR-MIND-BP in 60 seco