Remove 2009 Remove Fluid Resuscitation Remove Ultrasounds
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The CLOVERS Trial

Taming the SRU

It would be interesting to stratify the doses of vasopressor administration to the few potential adverse events (all of which resolved), or the location of the peripheral line, given the questions raised regarding safety and patency of ultrasound-guided IVs versus non-ultrasound guided-IVs. Jama 318 (13): 1233-1240. Bauer, M.,

Sepsis 52
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EM@3AM: Crush Injury

EMDocs

neurologic damage and thrombosis) 20,21 Resuscitation Lactated ringers > Normal saline due to reduced need for urinary alkalinization 22 Place foley and target urine output >300 mL/hr Electrolyte abnormalities Hyperkalemia: Obtain an ECG Stabilization: Calcium gluconate 2 g over 5-10 min. Published June 2009. Critical Care.

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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

EKG/ECG 52
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EM@3AM: Takotsubo Cardiomyopathy

EMDocs

Bedside ultrasound shows hypokinesis of the basal portion of the left ventricle with an apparent sigmoid-shaped septum and a dilated inferior vena cava. Ultrasound findings can show bulging of the interventricular septum into the LVOT , which can be interpreted as a sigmoid-shaped septum on bedside evaluation. The oral mucosa is moist.

EMS 74
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Sepsis Updates Relevant to the Emergency Physician

EMDocs

13,14 Fluids Fluid resuscitation is a mainstay of sepsis therapy, as the condition is commonly associated with both absolute and relative hypovolemia. 15 Two changes were elucidated in the 2021 SSC guidelines for fluid resuscitation. Additionally, the recommendation to use a 30 cc/kg bolus was downgraded.

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