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ToxCard: Iron

EMDocs

Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Case Follow-up: The patient received a fluid resuscitation with 20 mL/kg bolus of normal saline. Basic assessment: airway, breathing, circulation. Antiemetics as needed. Consider GI decontamination with whole bowel irrigation (WBI).

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EM@3AM: Leukopenia

EMDocs

Management is directed based on underlying etiology, but consider fluid resuscitation, antipyretics, and antibiotics as indicated. 2011 Feb 15;52(4):e56-93. Disposition is based on overall clinical presentation, inciting etiology, and consultant evaluation. Clin Infect Dis. doi: 10.1093/cid/cir073. PMID: 21258094.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

The time taken to measure serum hemoglobin and hematocrit (B) and await a result would delay definitive surgical control of likely ongoing hemorrhage given this patient’s incomplete response to fluid resuscitation. Epub 2011 Sep 10. Spontaneous retroperitoneal hematoma: etiology, characteristics, management, and outcome.

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SGEM#222: Rhythm is Gonna Get You – Into an Atrial Fibrillation Pathway

The Skeptics' Guide to EM

It is like normal saline vs. Ringer’s lactate for fluid resuscitation, steroids vs. no steroids for sepsis, or Coke vs. Pepsi. Dr. Ian Stiell and colleagues published an article in 2011 in Annals of EM looking at variation in recent-onset atrial fibrillation management in Canada and found a lot of variability.

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Paediatric IV Fluid Prescribing

Mind The Bleep

There could be any number of reasons for this but some examples are: they have severe D&V and aren’t keeping fluids down, or because they are pre or post-op, or have presented very unwell and need fluid resuscitation. saline + 5% dextrose or plasma-lyte 148 + 5% dextrose.

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First10EM Journal Club: October 2022

Broome Docs

PMID: 30206143 Less is more when it comes to intravenous fluids de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. PMID: 36103415 Bottom line: Less is more when it comes to intravenous fluids. 2011 Dec 15;343:d7506. 2018 Sep 11;362:k3843. N Engl J Med.

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The Intersections of Physical and Mental Health Disorders

ACEP Now

However, the persistence of tachycardia despite fluid resuscitation and dosing with lorazepam to help with his panic disorder raised concerns that warranted further investigation. Given his history, it could have been easy to attribute his current presentation to his known mental health conditions. Eur J Cardiothorac Surg.

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