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Putting Clinical Gestalt to Work in the Emergency Department

ACEP Now

Caring for critically ill patients with limited information requires snap assessments and judgements for timely resuscitation and efficient emergency department throughput. In this study, clinical gestalt is not only fast, but accurate for the benefit of timely resuscitation and intervention. Sound familiar? Classifying Facial Actions.

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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. The GCS should be measured after airway, breathing, and circulation are assessed, after a clear airway is established, and after necessary ventilatory or circulatory resuscitation has been performed.

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EM@3AM: Hyperthermia

EMDocs

Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. Ice water immersion and iced peritoneal lavage are additional methods used to lower temperature but are more invasive or can prevent additional resuscitative efforts.

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Large bowel obstruction: ED presentation, evaluation, and management

EMDocs

However, routine labs, including a complete blood count and metabolic panel, can guide resuscitative efforts preoperatively and may identify clinically relevant abnormalities associated with obstruction, including electrolyte changes, renal injury from hypoperfusion, or anemia secondary to underlying malignancy. 2007 Jan 21;13(3):432-7.

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Something she ate?

Intensive Blog

2007, Mar). 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. The model for end-stage liver disease (MELD). Hepatology, 45 (3), 797-805. link] All case-based scenarios on INTENSIVE are fictional.

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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.