Remove 2000 Remove Shock Remove Wellness
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But Can You Just PO?

Taming the SRU

Out of 18 patients receiving ORT, 4 failed to respond well and were escalated to IV therapy. Other contraindications include those who are unable to drink liquid (respiratory problems or impaired unconsciousness) and patients in shock, persistent vomiting, or with an ileus. AtherlyJohn et al. A systematic review by Freedman et al.

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Glasgow Coma Scale in Children

Pediatric EM Morsels

Pediatric adjusted reverse shock index multiplied by Glasgow Coma Scale as a prospective predictor for mortality in pediatric trauma. Fun fact for animal lovers!- cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! 2008 Apr;39(4):1347-8. doi: 10.1161/STROKEAHA.107.498345.

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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%

Sepsis 104
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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. Troponin T peaked at "only" just above 2000 ng/L. The patient ultimately did well. The patient was shocked — and then began a long intensive process of resuscitation. Then imagine drawing a vertical line intersecting the other QRS complexes.

EKG/ECG 133
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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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Is it Time to Take Another Look at the State of Emergency Care in the U.S.? 

ACEP Now

In 2000, as he was completing his second term on ACEP’s Board, he was elected to the IOM – now National Academy of Medicine – in 2000. We wanted to reach emergency physicians, nurses and others working in trauma as well as those at Health and Human Services and the Centers for Disease Control. National Academics.

EMS 45
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Maintenance Fluids in Critical Illness

Don't Forget the Bubbles

She had septic shock on presentation and was resuscitated with 60ml/kg of balanced crystalloid solution and escalating vasoactive medications. As well as considering volume, hyponatraemia is a harmful consequence of incorrect administration of fluids. Remember, we can add more if needed, but taking it away is much harder.