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Adjunctive Methylene Blue in Septic Shock?

RebelEM

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
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Trauma Resuscitation Updates

RebelEM

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%

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Snake Bites and Children

Pediatric EM Morsels

J Emerg Trauma Shock. Venomous snakebites in the United States: management review and update [published correction appears in Am Fam Physician 2002 Jul 1;66(1):30]. as far west as Texas Cottonmouths/Water Moccasins live in the southeastern U.S. in wetlands, rivers, and lake areas Coral snakes inhabit the southern U.S. 2008;1(2):97-105.

CDC 130
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SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock

The Skeptics' Guide to EM

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. He writes an […] The post SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock first appeared on The Skeptics Guide to Emergency Medicine. Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. NEJM January 2018.

Shock 40
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emDOCs Podcast – Episode 103: Thermal Burn Injury

EMDocs

American Burn Association Clinical Practice Guidelines on Burn Shock Resuscitation. 2002 Mar;68(3):240-3; discussion 243-4. 2002 Nov;28(7):665-9. [link] (2019). Cartotto R, Johnson LS, Savetamal A, Greenhalgh D, Kubasiak JC, Pham TN, Rizzo JA, Sen S, Main E. J Burn Care Res. 2024 May 6;45(3):565-589. 2004;329(7457):101-103.

Burns 86
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EM@3AM: Stercoral Colitis

EMDocs

2, 8-10, 14 The clinical symptoms range from vague abdominal pain to florid septic shock and peritonitis secondary to bowel perforation. If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. ISSN 2002-4436. Cureus, 15(12), e50511.

EMS 88
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SGEM#391: Is it Time for a Cool Change (Hypothermia After In-Hospital Cardiac Arrest)?

The Skeptics' Guide to EM

The patient is in ventricular fibrillation, and you achieve return of spontaneous circulation (ROSC) on the second shock. Since 2002, we have seen several larger trials that have raised questions about the value of hypothermia. The patient is still unconscious. A post-arrest ECG doesn’t show any signs of STEMI.