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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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Large bowel obstruction: ED presentation, evaluation, and management

EMDocs

3 Point of care ultrasound (POCUS) can be highly sensitive for free fluid and pneumoperitoneum when used by a trained physician in the appropriate patient population. 2007 Jan 21;13(3):432-7. 9 POCUS has utility for the critically ill patient who may not be appropriate for CT to assess for perforation. World J Gastroenterol.

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Something she ate?

Intensive Blog

Other investigations to consider include imaging of the liver with ultrasound and computerised tomography (CT) to assess for any changes to the liver parenchyma or vasculature, such as portal vein thrombosis or Budd Chiari Syndrome (hepatic venous outflow obstruction). 2007, Mar). Bellomo, R. 2014, Jan). link] Kamath, P.

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

EMDocs

Over the last few years, however, ultrasound has been increasingly playing an important role in the conversation with multiple studies looking at using ultrasound to predict fluid responsiveness in septic patients – for example, using the velocity time integral with passive leg raise. 2007 Feb;24(2):124125.