RebelEM

MAY 25, 2023

I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. Clinical Take Home Point: In patients with TBI and hypovolemic shock, target a SBP or MAP ≥90mmHg, but know this is based on limited evidence. vs SBP target <90mmHg which resulted in a mortality of 33.4% NEJM 1994. [2] NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

RebelEM

FEBRUARY 24, 2025

13 That is to say nothing of the effect that the type and response to shock has on the individual patients involved in these studies. Simply put, a difference greater than or equal to 12% between the largest and smallest pulse pressure can predict fluid responsiveness. Jul 2010; PMID: 20620859. J Am Soc Echocardiogr.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

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

Northwestern EM Blog

FEBRUARY 14, 2022

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. were more likely to respond.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

EMDocs

DECEMBER 16, 2023

Heat stroke can lead to end-organ dysfunction such as rhabdomyolysis, disseminated intravascular coagulation, cardiogenic shock, liver failure, and cerebral edema. Broad-spectrum antibiotics (A) for septic shock are not inappropriate given the hyperthermia, tachycardia, and hypotension. Temps greater than 41.5C link] Larach, M.

Hyperthermia / Hypothermia 96

Hyperthermia / Hypothermia EMS Stroke Seizures 96

EMDocs

JANUARY 20, 2025

Patients were enrolled in these trials if they had signs of shock, with mortality ranging from 18-29%. One of the hallmarks of sepsis care, based on the Rivers 2001 17 trial and still recommended by the latest SCCM guidelines is early detection of sepsis and initiation of early resuscitation. Similar to Andrews et al., Inwald et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75