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Putting Clinical Gestalt to Work in the Emergency Department

ACEP Now

In such cases, would you wait for a lactate, white blood cell count, bandemia, or other diagnostics to confirm a source of infection before starting antibiotics, fluid resuscitation, and/or pressors? In this study, clinical gestalt is not only fast, but accurate for the benefit of timely resuscitation and intervention.

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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. Fluid Resuscitation Intravenous fluids should be administered in the prehospital setting to treat hypotension and/or limit hypotension to the shortest duration possible.

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Large bowel obstruction: ED presentation, evaluation, and management

EMDocs

Measures to optimize the patient for surgical intervention and treat shock, including antibiotics and fluid resuscitation, are associated with improved outcomes in these patients. 2007 Jan 21;13(3):432-7. 5 Non-perforated obstruction due to malignancy will usually be managed with urgent surgery. World J Gastroenterol.

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EM@3AM: Hyperthermia

EMDocs

Temps greater than 41.5C per minute) 1,4 Body bag may be utilized if no immersion tank available 3 Evaporative cooling (DT 0.1C link] Gaudio, & Grissom, C. Cooling Methods in Heat Stroke. The Journal of Emergency Medicine. , 50 (4), 607–616. link] Bouchama, Dehbi, M., & Chaves-Carballo, E. Becker, S. Yeargin, S. Siegler, J., Blowers, J.

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Something she ate?

Intensive Blog

2007, Mar). Vasopressors such as noradrenaline are often required (systemic vasodilation is common in hepatic failure). .; Bellomo, R. 2014, Jan). Preventing cerebral oedema in acute liver failure: the case for quadruple-H therapy. Anaesth Intensive Care, 42(1), 78-88. link] Kamath, P. S., & Kim, W. Hepatology, 45 (3), 797-805.

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

EMDocs

For patients without frank signs of shock, it is reasonable to trial oral hydration prior to moving on to IV fluids. 2007 Feb;24(2):124125. The Restrictive IV Fluid Trial in Severe Sepsis and Septic Shock (RIFTS): A Randomized Pilot Study. Fluid resuscitation in sepsis: the great 30 mL per kg hoax. Ann Emerg Med.