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Pediatric emergency medicine trisk 483

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Initial management Remove from contaminated environment Cardiopulmonary resuscitation as needed Provide 100% supplemental oxygen Consider hydroxocobalamin injection (Cyanokit) if concern for cyanide toxicity Ensure patent airway Laboratory determinations Arterial blood gas analysis Carboxyhemoglobin level, cyanohemoglobin level, troponin Chest radiograph Monitor Heart rate, electrocardiogram, respiratory rate, blood pressure, Sao2 Consider central venous pressure Consider pulmonary artery catheterization Fluids 5% dextrose in normal saline at maintenance rates or less to maintain urine output at 0.5–1.0 mL/kg/hr Volume expansion in presence of cutaneous burns; normal saline, lactated Ringer solution, or 5% albumin Respiratory management Intubation for: Upper airway obstruction Pao2

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