Remove 2010 Remove Resuscitation Remove Shock
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Trauma Resuscitation Updates

RebelEM

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]

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TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

RebelEM

As described in the CONSORT statement, the use of p-values in table 1 is inappropriate as the study is not powered to show a difference in baseline characteristics between the treatment and control group in an RCT (Schulz 2010). CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med.

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SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest

The Skeptics' Guide to EM

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Reference: Cashen K, Reeder RW, Ahmed T, et al.

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Vasopressor Nonresponse

Northwestern EM Blog

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

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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.

Shock 52
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Diagnostics and Therapeutics: Arterial Lines and Invasive Blood Pressure Monitoring

Taming the SRU

One such study of 263 patients without hypertensive emergencies treated in a resuscitation unit found that 40% of patients had a MAP difference ≥ 10 mmHg between IABP and NIBP measurements. A recent observational study was performed to pragmatically assess clinically meaningful differences in BP in a diverse critically ill cohort with shock.

Shock 59
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Early Modern Resuscitators

Advanced Emergency Nursing from AENJ

Although told several times, the story of the development by Henning Ruben of the prototypical modern manual resuscitator, the self-refilling bag with unidirectional non-rebreathing valves which now dominate the world of resuscitation, is still not well-known. Czech Military resuscitation kit, 1969, mfr.