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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.

EMS 74
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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.

EKG/ECG 52
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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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Referring to the Intensive Care Unit

Mind The Bleep

2011 Dec;11(6):601-4. University of Aberdeen (2020) Making decisions about who to admit to Intensive Care, University of Aberdeen. Available at: [link] (Accessed: 09 February 2024). Fullerton JN, Perkins GD. Who to admit to intensive care? Clin Med (Lond). doi: 10.7861/clinmedicine.11-6-601. PMID: 22268319; PMCID: PMC4952346.

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Episode 7: Sepsis

PHEM Cast

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. 2011 Aug 30;18(9):934–40. Academic Emergency Medicine.

Sepsis 52
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Necrotising Enterocolitis

Don't Forget the Bubbles

Initial Management Supportive Care : Initial management involves stabilising the infant, which includes fluid resuscitation, cessation of enteral feeds, and provision of total parenteral nutrition (TPN) to rest the bowel and meet the nutritional needs of the infant. How do you treat necrotising enterocolitis? Necrotizing enterocolitis.

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Back to the BaSICS: does the infusion rate of a fluid bolus affect mortality?

PulmCCM

Yet in 2011 a landmark randomized, controlled trial measured the effect that an intravenous bolus had on mortality in children with severe febrile illness in 3 African countries. Septic sheep randomized to early, rapid volume resuscitation had greater vasopressor requirements 12 hours after initial fluid bolus.