RebelEM

MAY 29, 2023

septic shock). Limited, small studies on its use in septic shock do not make a clear argument for use. Early Adjunctive Methylene Blue in Patients with Septic Shock: A Randomized Controlled Trial. Background: Sepsis can induce numerous physiologic derangements. Paper: Ibarra-Estrada, M et al. Crit Care 2023. 95% CI 15.4

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

RebelEM

MAY 25, 2023

I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. Clinical Take Home Point: In patients with TBI and hypovolemic shock, target a SBP or MAP ≥90mmHg, but know this is based on limited evidence. vs SBP target <90mmHg which resulted in a mortality of 33.4% NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Greater Sydney Area HEMS

APRIL 26, 2023

– Eventual hospital assessment demonstrated no traumatic injuries. In contrast, shock (leading to syncope and rarely cardiac arrest) from ST can occur well before mechanisms of crush injury come into play, with low-flow states described as early as within 6 minutes (2). UK Health and Safety Executive, London; 2002.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Shock Research Operations 52

ACEP Now

MAY 9, 2024

The procedure has soared in popularity as beauty standards have shifted and cosmetic surgery has become increasingly transparent on social media platforms, with reported cases in the United States increasing from 614 in 2002 to 61,387 by 2021, a nearly 10,000 percent increase. References Garcia SE. Butt Lifts Are Booming.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Don't Forget the Bubbles

JULY 26, 2023

For anyone approaching a structured ABC would be a priority to establish whether shock was present or not. Typical features include: HR >220bpm Narrow complex regular tachycardia P waves difficult to identify In this case there is no shock present so we can proceed to the right branch of the ALSG guideline.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

ACEP Now

MARCH 14, 2024

Electrical injuries—excluding lightning injuries—account for roughly 10,000 nonfatal shock incidents a year and 500 deaths a year. Dr. Koo is faculty and an emergency physician at MedStar Washington Hospital Center in Washington, D.C., Mary’s Hospital in Leonardtown, Maryland. 30(11):p S424-S430, November 2002.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

PHEM Cast

APRIL 18, 2016

All things Pre Hospital Ketamine – Minh Le Cong Key point: patients remember if you manage their pain well. Hauwald, 2002 A co-operative patient does not require immobilization unless their conscious level deteriorates. We have also recorded a three interviews already which will feature in future podcasts.

Fractures 40

Fractures Operations Administration Shock 40

Pediatric Emergency Playbook

JANUARY 1, 2017

Neonatal pain pathways are particularly plastic; prompt assessment of and increased alertness to neonatal pain may help to mitigate long-lived pain sensitivity and hyperalgesia ( Taddio 2002 ). For many medications, these children will have a greater weight-normalized clearance than adults ( Berde 2002 ). 2002 Oct 3;347(14):1094-103.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

JANUARY 20, 2025

Patients were enrolled in these trials if they had signs of shock, with mortality ranging from 18-29%. 13 While there is good data that early antibiotics for patients in septic shock reduce mortality 18-19 the role of early and aggressive volume resuscitation and its impacts on patient-centered outcomes remain unclear. Inwald et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

FEBRUARY 24, 2025

Two-month-old Isla presents to their local hospital following a prolonged apnoea at home. The condition increases blood viscosity and pulmonary vascular resistance, leading to pulmonary hypertension, haemodynamic collapse, and, ultimately, death due to hypoxaemia and refractory shock. They had a two-day history of reduced feeding.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59