Clinical Tips
Quick and practical tips for your nursing practice
💡 Sometimes the Best Treatment Is No Treatment
Permissive hypertension applies when ALL 3 criteria are met: 1. Patient NOT receiving reperfusion no tPA, no EVT 2. BP
👤 Eleanor, 71, post-tPA, slightly more drowsy
NIHSS 12. tPA only no EVT. BP trending up: 162 → 168/98. Target should be 130-140. You notice subtle drowsiness. STAT
💡 Stability Matters as Much as the Target
BP variability is an independent predictor of poor outcomes: • ↑10mmHg SBP variability → 14% less chance of favorable o
🎯 FAIR: Pediatric Abdominal Emergencies
F — Fatal: Use ABC — Volvulus neonate, Intussusception infant, Appendicitis child >5 A — Assess: Age = first diagnostic
📋 ABC of Pediatric Abdominal Emergencies
A = 0-1 month → Volvulus Red flag: Bilious green/yellow vomiting → Emergent upper GI series B = 2 months - 2 years → I
🚨 Bilious Vomiting in a Neonate = Surgical Emergency
Green or yellow vomiting in a baby <1 month is NEVER reflux. NEVER formula intolerance. It is malrotation with volvulu
🚨 Lethargy in an Infant Can Be the ONLY Sign of Intussusception
No crying. No leg-drawing. Just a sleepy baby. Don't wait for the classic triad. Lethargy alone in an infant with ANY
❌ Myth: "Child looks fine now — can't be serious"
Reality: Well appearance between episodes IS the pattern of intussusception Children with intussusception can seem pe
👤 Marcus, 11 months, "keeps screaming then falls asleep"
Episodes of crying, drawing up legs. Drowsy between episodes. Refused his bottle. No fever. No diarrhea. Triage note s
💡 Every Male With Abdominal Pain Needs a Genital Exam
Testicular torsion presents as REFERRED abdominal pain. The child complains of belly pain while the testicle is dying.
❌ Myth: "Withhold pain meds until the surgeon sees the patient"
Reality: 3 clinical trials confirm analgesia does NOT mask surgical diagnosis Evidence Kim, Green, Bailey trials: • D
🎯 FAIR: qSOFA Bedside Assessment
F — Fatal: Sepsis kills 350,000+ Americans/year — most saw a provider before crashing A — Assess: RR-MIND-BP in 60 seco