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The Latest in Critical Care, 2/19/24 (Issue #30)

PulmCCM

Panelists called this “low certainty evidence from five before-after studies that this intervention may be associated with lower mortality and fewer unsuccessful resuscitation events.” Over six years of study (2007-2013): There were 83 MET calls activated by parents (~1.2 Well … no. Let’s take a closer look.

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Vasopressor Nonresponse

Northwestern EM Blog

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. There is a subset of patients who, despite aggressive conventional resuscitation, have an inadequate hemodynamic response and develop refractory shock. 2007; 25: 309-331.

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The Technologically Dependent Child in the ED

Pediatric Emergency Playbook

The Huber needle is not a resuscitative line. Increased demand may be temporary, such as in burns, s/p cardiac surgery, or ay prolonged recovery. Vascular Devices: assume the line is not functional, and use another to resuscitate, especially in port-a-caths. Gastroenterol Clin N Am 36 (2007) 123-144l Feinberg A et al.

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Proper Preparation for Mass Casualty Incidents

Northwestern EM Blog

This post will discuss a brief overview of hospital planning and operational setup with key elements of a disaster response from events that cause high numbers of blunt trauma, penetrating trauma, burns or crush injuries that may be seen following explosive events, mass shootings, or large scale motor vehicle collisions, to name a few.

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Pediatric Pain

Pediatric Emergency Playbook

Surgical pain is not “erased” by opioids ( Thomas 2003 , Poonai 2014 ); treating pain improves specificity to certain surgical emergencies with retained diagnostic accuracy ( Manterola 2007 ). Pediatric burns should be assessed carefully and treated aggressively. Minor burns can be treated topically and with oral medications.

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IV fluids in the ED: When do we really need them?

EMDocs

Sepsis There has been much controversy over the last two decades around the various nuances of volume resuscitation in ED patients with suspected sepsis, much of which goes beyond the scope of this limited review. In lower-resource settings, the evidence is stronger against a liberal approach to volume resuscitation. Andrews et al.