Emergency Medicine Cases EM Quick Hits 63 S-TEC and HUS, IM Epinephrine in OHCA, Dengue, Geriatric Trauma Imaging, TTP
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Mar 11, 2025 
Stephen Freedman, a pediatric emergency medicine expert, discusses diagnosing pediatric bloody diarrhea and the risk of hemolytic uremic syndrome. Matthew McArther sheds light on the diagnosis and management of dengue fever in travelers, emphasizing its critical phases. Andrew Petrosoniak explores imaging strategies for geriatric trauma patients, highlighting tailored protocols. They also question the use of intramuscular epinephrine in out-of-hospital cardiac arrests and delve into thrombotic thrombocytopenic purpura, its urgent recognition, and treatment.
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Stool Specimen for Bloody Diarrhea
- Obtain a stool specimen for children with bloody diarrhea to determine the etiology.
- This is the frontline diagnostic tool, guiding subsequent management.
PCR for Stool Testing
- Most North American institutions use PCR, not cultures, for initial stool testing.
- PCR tests typically include Salmonella, Shigella, Campylobacter, and STEC (Shiga toxin-producing E. coli).
Bloodwork in Pediatric Bloody Diarrhea
- Avoid routine blood work for stable children with mild bloody diarrhea.
- Consider blood work if STEC is suspected, if the child is severely dehydrated, or other high-risk features.