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SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock

The Skeptics' Guide to EM

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. Guest Skeptic: Dr. Rory Spiegel (@EMNerd_) is a clinical instructor at University of Maryland, a recent graduate of Stony Brook’s Resuscitation Fellowship, and a current Critical Care fellow at University of Maryland. NEJM January 2018. NEJM January 2018.

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Review of the ATHOS 3 trial

Northwestern EM Blog

The ATHOS-3 trial in 2017 explored the efficacy of angiotensin II as a vasopressor for severe vasodilatory shock. Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation.

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Episode 28: LOST

PHEM Cast

It might be better to consider traumatic cardiac arrest as a completely different disease eg LOST: Low Output State due to Trauma The 2015 European Resuscitation Council and UK Resuscitation Council Algorithms for Traumatic Cardiac Arrest: To read the whole ERC guideline on special circumstances cardiac arrest including trauma, click here.

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Etomidate: a perspective on a current controversy.

Thinking Critical Care

In 1983 I was an Englishman abroad, the London anaesthetist who was appointed to be the English anaesthetist on the Shock Team only because the outstanding candidate from Oxford had preferred to take up a job doing muscle relaxant research with Kitz and Katz in the USA. 4] The research agenda at the time was broad.

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POCUS findings of hemodynamically unstable PE with cardiac arrest

EMDocs

However, as shock resolved and hemodynamic stability improved, RV strain and underfilling of the LV remained apparent 30 minutes after ROSC (Vid 4). During this resuscitation two different ultrasound machines were used to capture images due to a malfunction with the first machine after initial images were captured. Am J Prev Med.

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The Technologically Dependent Child in the ED

Pediatric Emergency Playbook

He is in compensated shock. The Huber needle is not a resuscitative line. Vascular Devices: assume the line is not functional, and use another to resuscitate, especially in port-a-caths. Pediatr Clin N Am 55 (2008) 1343–1358 Garton HJ. Pediatr Clin N Am 55 (2008) 1299–1314 Munck A et al. Hydrocephalus.

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Cholera: ED presentation, evaluation, and management

EMDocs

The clinical picture of this patient was consistent with hypovolemic shock secondary to acute cholera infection. Rehydration therapy for patients with cholera should include volume resuscitation and electrolyte repletion. Laboratory testing was not immediately available. How is this condition diagnosed and treated in the ED?