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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. Published 2012 Jul 1.

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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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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
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Episode 16: “Blood”

PHEM Cast

Priorities for the bleeding trauma patient must include: Minimum time to control of bleeding (tourniquets / haemostatics / knife / interventional radiology) Normothermia Appropriate choice of destination (knife / IR) ? We believed in permissive hypotension – we were probably wrong. Lots to think about! 2016 Jul;46(1):3–16.

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REBEL Core Cast 94.0 – SBO

RebelEM

J Trauma Acute Care Surg 2012; 73(5): S362-9. Radiology US 90% 96% 14.1 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1

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Milestones of Modern Progress in Emergency Care

Advanced Emergency Nursing from AENJ

Perhaps, not insignificantly, they were accustomed to receiving systematized government-supplied medical and trauma care, with "shock rooms" receiving an influx of victims, as contrasted to those later who opposed "socialized medicine." Committee on Shock. 1950s & 1960s Resuscitation Research. Trimble, Tom, RN CEN.

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MI in Children

Pediatric Emergency Playbook

The Systemic Lupus International Collaborating Clinics (SLICC) revised the criteria in 2012. The infant in shock after a ‘cold’: myocarditis Beware of the poor feeding, tachycardic, ill appearing infant who “has a cold” because everyone else around him has a ‘cold’. 2012; AID 471759. 2012; 7:19796. 2012; 59(13):1123-1133.