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PECARN Pediatric Head CT Rule

The PECARN head injury rule was derived in a population of patients younger than 18 years old with blunt head injury. 42412 patients were included in the study population with a goal of identifying patients at very low risk of clinically important traumatic brain injury (ciTBI) by history and exam criteria, obviating the need for CT imaging.  Child <2 yo

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HIV PEP – Non-occupational

Preferred Regimen For Non-Occupational Post-Exposure Prophylaxis Raltegravir 400mg PO Twice Daily (Isentress®; RAL) Plus Truvada™,1 PO Once Daily [Tenofovir DF (Viread®; TDF) 300mg + emtricitabine (Emtriva™; FTC) 200mg]   Summary of CDC Guidelines: When care is sought ≤72 hours after a potential nonoccupational exposure that presents a substantial risk for HIV acquisition. Obtain screening labs. Test exposed patient AND source

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HIV PrEP – Pre-Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) has been recommended by the CDC since 2014 as one option for prevention of HIV transmission in adults at high risk. There is only one FDA approved drug for this indication.   Truvada 200mg/300mg, 1 tab PO daily [emtricitabine (FTC) 200 mg and tenofovir disoproxil fumarate (TDF) 300 mg] PrEP is recommended for the following populations: Sexually-active adult MSM (men

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HIV PEP – Occupational

HIV Occupational Post-Exposure Prophylaxis Regimen:   Raltegravir 400mg PO Twice Daily (Isentress®; RAL) Plus Truvada™,1 PO Once Daily [Tenofovir DF (Viread®; TDF) 300mg + emtricitabine (Emtriva™; FTC) 200mg] CDC Recommended approach: 1) Evaluate exposure: Exposures posing risk of infection transmission : Percutaneous injury Mucous membrane exposure Non-intact skin exposure Bites resulting in blood exposure to either person involved Substances posing risk of infection transmission:

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Toxidromes

US Poison Control Center Hotline 1-800-222-1222 Anticholinergic Syndrome Physiology:Inhibition of muscarinic cholinergic neurotransmission (blocking acetylcholine from binding receptors) gives these drugs their effect. Receptors are found on smooth muscle in the GI tract, bronchi, heart, salivary and sweat glands, the cilliary body of the eye, Drugs: antihistamines, sleep aids, tricyclic antidepressants, cold preparations, atropine, cyclopentalate (eye drops) Plants: deadly nightshade (belladonna), jimson weed Clinical Features: “Red as

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CT Contrast and Kidneys (FAQ)

American College of Radiology Manual on Contrast Media (download pdf): 1) Do end-stage renal patients need urgent dialysis after a CT scan with IV contrast? No “Most low-osmolality iodinated contrast media are not protein-bound, have relatively low molecular weights, and are readily cleared by dialysis. Unless an unusually large volume of contrast medium is administered, or there is substantial underlying

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Pediatric Fever Protocols

There have been several attempts at building protocols for pediatric fever in order to determine what children 3 months and younger can be discharged home. The most commonly used protocols include the Rochester, Philadelphia, and now Step-by-Step. Although there is an exceptional comparison of these protocols (Step by Step not included) from Hui et al in 2012, the most important

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