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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. AtherlyJohn et al. A systematic review by Freedman et al.

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

Dr. Smith's ECG Blog

The ST elevation in V2-V6 as well as in I and aVL becomes easily recognizable. Resuscitation efforts were undertaken. ECG#3 Resuscitation efforts were ongoing. Troponin T peaked at "only" just above 2000 ng/L. The patient ultimately did well. The patient went in and out of ROSC. Is there OMI? An ICD was placed.

EKG/ECG 133
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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. This could have influenced care the patients received as well as reporting of adverse events (i.e. Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4 Liberal: 14.9% Liberal: 14.9%

Sepsis 104
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Electrical injuries

Don't Forget the Bubbles

The high voltage can cause direct thermal injuries, as well as mechanical injuries from falls or secondary trauma. Judicious fluid resuscitation is critical; patients may become volume-deplete due to fluid loss/oedema secondary to burns. Volume resuscitation in patients with high-voltage electrical injuries. Resuscitation.

Burns 80
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Brain Trauma Guidelines for Emergency Medicine

ACEP Now

This document is an update of guidelines first published in 2000, and then updated in 2007. Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented.

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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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EM@3AM: Endometritis

EMDocs

doi: 10.1002/(SICI)1098-0997(2000)8:2<77::AID-IDOG3>3.0.CO;2-6. Evaluate for retained products of conception as etiology Diagnosis Diagnosis of endometritis with at least two of the following: 8 Fever >100.4F Prevalence and clinical significance of postpartum endometritis and wound infection. Infect Dis Obstet Gynecol.

OB/GYN 91