PHEM Cast

APRIL 10, 2016

The control group received many similar treatments as the ‘intervention’ group (just not full protocolised EGDT) highlighting that with good sepsis care (fluid resuscitation, close monitoring, early appropriate antibiotic administration), mortality can be reduced. 2010 Apr;38(4):1045–53. 2010 Apr;14(2):145–52.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Pediatric EM Morsels

JULY 28, 2023

The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. Low morbidity and mortality in children with diabetic ketoacidosis treated with isotonic fluids. 2010 Dec;1(2):103-20. The mortality rate for cerebral edema is 21%–24%.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

RebelEM

MAY 25, 2023

Lancet 2010 [10] >20,000 adult trauma patients with SBP <90mmHg Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs Placebo given within 8hrs of injury In-hospital mortality by 28d reduced (14.5% Hypotensive resuscitation during active hemorrhage: impact on in-hospital mortality. NEJM 1994. [2] NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Mind The Bleep

MAY 12, 2023

Administration of human albumin solution (HAS) in SBP reduces the incidence of renal failure by 72% and mortality by 47%. In those who are grossly obese, it may be better to employ a more cautious approach with regard to albumin administration. 2010 Feb;12(1):1-6. On Day 3 (i.e. 48 hours later) albumin is administered at 1g/kg.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

Taming the SRU

MARCH 31, 2023

Yates Anaphylaxis Pathophysiology Type 1 Hypersensitivity Reaction IgE-mediated Mast-cell degranulation of vasoactive materials Reaction occurs in minutes Clinical Definition: Acute onset of illness with involvement of the skin, mucosal tissue or both + one of the following Respiratory compromise Reduced BP Or, acute onset of illness with at least (..)

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

EMDocs

JANUARY 20, 2025

Since the 2010s multiple trials have explored the feasibility of fluid restrictive resuscitation both on initial resuscitation in the ED, as well as in the intensive care unit (ICU). It may be reasonable to consider IV fluid administration in patients with moderate dehydration or prolonged vomiting.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75