PALS

Question 1

Empyema

Answer 1

A collection of pus in a body cavity, especially the pleural cavity. In empyema, pus fills a normal body cavity whereas in abcess, pus creates a new cavity.

Question 2

Pneumonia that is most likely to cause pleural empyema

Answer 2

Staphlococcus Aureus Pneumonia

Question 3

In children, ICP (increased cranial pressure) most often presents with:

Answer 3

irregular breathing
tachycardia
hypertension

Question 4

Myocardial Dysfunction

What is it?
What causes it?
What to DO about it?

Answer 4

A common complication of Sepsis

Bilateral ventricular malfunction is thought to be due to impact of circulating TNF and IL on the actual myocytes and is most detectable via echocardiogram - TEE can be used.

This malfunction tends to be refractory to fluid resuscitation and to pressor use. There isn’t much to do but get the right ABX on board, keep Bp up with fluids and pressers and you can add an inotropic agent but, for a totally reversible condition, it certainly can get scary.

Use DOBUTAMINE as your inotrope