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EM@3AM: Murine Typhus

EMDocs

2012 Jun 30;43(2):175-80. Ischemic Hepatitis and Septic Shock Secondary to Murine Typhus Infection in Pregnancy. The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. Food and Drug Administration. MMWR Morb Mortal Wkly Rep. 2003;52(50):1209-1211. Accessed August 19, 2024. Colomb Med (Cali).

EMS 101
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EM@3AM: Stercoral Colitis

EMDocs

2, 8-10, 14 The clinical symptoms range from vague abdominal pain to florid septic shock and peritonitis secondary to bowel perforation. If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. 2012 May-Jun;13(3):283-289. Korean J Radiol.

EMS 94
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ToxCard: Iron

EMDocs

In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. Published 2012 Jul 1. 2012 Aug;39(8):719-24.

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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%

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52 in 52 – #41: The CENSER Trial

EMDocs

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 86
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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

In cardiac arrest, a delay in IV access subsequently results in a delay in epinephrine administration. 2012 PMID: 21893125. Intravenous vs intraosseous adrenaline administration in cardiac arrest: A protocol for systematic review and meta-analysis. Resuscitation. 9 Zhang W et al. Medicine (Baltimore).

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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. 2012 Aug;43(2):e157-61. For blunt injury to zone III, an alternative method for hemorrhage control should be pursued (e.g., angioembolization). J Emerg Med.

EMS 93