Remove 2000 Remove Resuscitation Remove Shock
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REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

RebelEM

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. The goal of the trial was to see if early vasopressors improved shock control by 6 hours. This resulted in better shock control by 6hrs (76.1% Liberal: 14.9% Liberal: 14.9%

Sepsis 105
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Very fast regular tachycardia: 2 ECGs from the same patient. What is going on?

Dr. Smith's ECG Blog

Resuscitation efforts were undertaken. ECG#3 Resuscitation efforts were ongoing. Troponin T peaked at "only" just above 2000 ng/L. The patient required resuscitation for recurrent polymorphic VT — but fortunately was successfully transferred to the PCI center, where reperfusion was achieved. Is there OMI? Is there OMI?

EKG/ECG 134
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Electrical injuries

Don't Forget the Bubbles

Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)? Children, especially toddlers, may insert objects into outlets, leading to shocks or burns. Electrical devices used near water sources can cause severe shocks. Was the voltage high or low (as below)?

Burns 80
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But Can You Just PO?

Taming the SRU

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. Patients present to the ED with hypovolemia secondary to a plethora of causessome requiring IV fluid resuscitation and others requiring none.

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Issue #2: The Latest in Critical Care, 5/22/23

PulmCCM

Read in NEJM Fluid resuscitation and vasopressors are both usually needed in septic shock , but the ideal volume of fluid to infuse before starting vasopressors has been unclear. At least one expert questioned whether the study was adequately powered. In an NHLBI-sponsored trial enrolling 1563 patients at 60 U.S.

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Maintenance Fluids in Critical Illness

Don't Forget the Bubbles

In a PICU setting, sodium can come from various sources (resuscitation fluids, IV drugs and infusions, enteral feed), not just the maintenance fluids we prescribe. There is growing interest in giving no maintenance fluid and using the input from drug infusions and resuscitative boluses only. Most drugs are chosen to be dissolved in 0.9%

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Adventures in RSI

Pediatric Emergency Playbook

We have a few minutes to optimize, to resuscitate before we intubate. Etomidate is perfectly acceptable, but ketamine is actually a superior drug to etomidate in the rapid sequence intubation of children in septic shock. in Anethesia and Analgesia in 2000. She needs her airway taken over. Give a test dose of 10 mL/kg NS.

Shock 40