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EM@3AM: Retroperitoneal Hematoma

EMDocs

Clinical features include abdominal or flank pain; ecchymosis to the flank, periumbilical region, proximal thighs, or scrotum; and hemorrhagic shock early in the disease course. Epub 2011 Sep 10. For blunt injury to zone III, an alternative method for hemorrhage control should be pursued (e.g., angioembolization). J Emerg Med.

EMS 87
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Grand Rounds Recap 8.16.23

Taming the SRU

to divert the plane). for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 95
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ToxCard: Iron

EMDocs

Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. 6 Severe toxicity and shock are typically seen with serum iron concentrations above 500 g/dL and serum iron concentrations above 1000 g/dL are associated with significant mortality. 2 L/hr in adults. Hosking CS.

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Coffee and Cases Snippets: Don’t Leave Me In Suspense

Greater Sydney Area HEMS

In contrast, shock (leading to syncope and rarely cardiac arrest) from ST can occur well before mechanisms of crush injury come into play, with low-flow states described as early as within 6 minutes (2). . Although remember, as is observed intra-operatively from tourniquet application, muscle can tolerate hours of hypoxia. Merchant D.

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Impact of Emergency Department Crowding on Lung Protective Ventilation

RebelEM

4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. More pertinent and relevant takeaway messages have to do with staffing and operations. 2011 Feb 15; Epub 2010 Aug 27. Prior studies have used annual census or shift level crowding. PMID: 19325480 Gajic O, et al.

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Multisystem Trauma in Children, Part One: Airway, Chest Tubes, and Resuscitative Thoracotomy

Pediatric Emergency Playbook

REBOA If you have access to resuscitative endovascular balloon occlusion of the aorta or REBOA, this may be an option to temporize the child to get him to the relative control of the operating room. They used REBOA for refractory hemorrhagic shock due to either blunt or penetrating injury. 2011 Dec;71(6):1869-72. Brenner et al.

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Episode 20: End Tidal Carbon Dioxide

PHEM Cast

You can also see when your treatment is working- if you give a patient in septic shock some fluid and improve their CO, you’ll see a rise in ETC02 You can confirm adequacy of respiratory function in the fitting or post-ictal patient when all other methods fail PITFALLS Device failure- lines blocking, batteries running out, pump failure.

CPR 52