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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. These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations.

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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. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. 2007 Jan 21;13(3):432-7.

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EM@3AM: Hyperthermia

EMDocs

Clinical characteristics and outcome of thyroid storm: a case series and review of neuropsychiatric derangements in thyrotoxicosis. Outcome and risk factors associated with extent of central nervous system injury due to exertional heat stroke. Temps greater than 41.5C link] Gaudio, & Grissom, C. Cooling Methods in Heat Stroke.

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

EMDocs

One of the hallmarks of sepsis care, based on the Rivers 2001 17 trial and still recommended by the latest SCCM guidelines is early detection of sepsis and initiation of early resuscitation. link] During the 2017 IV fluid shortage, Patino et al. Inwald et al. Choudhari et al.