Remove 2013 Remove Fluid Resuscitation Remove Resuscitation
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Cerebral Edema and Diabetic Ketoacidosis: Rebaked

Pediatric EM Morsels

The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. Low morbidity and mortality in children with diabetic ketoacidosis treated with isotonic fluids. 2013 Sep;163(3):761-6. The mortality rate for cerebral edema is 21%–24%.

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IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

RebelEM

Does the Central Venous Pressure Predict Fluid Responsiveness? July 2013; PMID: 23774337 Cavallaro, F et al: Diagnostic accuracy of passive leg raising for prediction of fluid responsiveness in adults: systematic review and meta-analysis of clinical studies. Oct 2013; PMID: 24079262 Gohar E, et al. Marik P, et al.

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Chemical Burns

Mind The Bleep

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications. 2013 May;74(5):1363-6. Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. J Trauma Acute Care Surg.

Burns 52
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EM@3AM: Stercoral Colitis

EMDocs

If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. The two highest predictors of increased mortality in the literature include a large area of colonic involvement >40cm and perforation (32-60% mortality rate). link] Chakravartty, S.,

EMS 98
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52 in 52 – #41: The CENSER Trial

EMDocs

Additionally, 80% of patients in the control group required open label NE use indicating that NE was going to be needed in most of these patients regardless of initial resuscitation method. The median amount of fluids administered between the groups before initiation of NE was not statistically significant (2080 mL vs. 1900 mL).

Sepsis 95
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Diabetic Ketoacidosis in Paediatrics

Mind The Bleep

It is also vital to do a fluid balance assessment. Majority of DKA patients are in a fluid deficit and present acutely with shock. Therefore, they require fluid resuscitation to restore blood pressure, correct the ketonemia and electrolyte abnormalities, and oliguria. This is done with an initial bolus of 10ml/kg 0.9%

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Tasty Morsels of Critical Care 046 | Abdominal Compartment Syndrome

Emergency Medicine Ireland

They even have a set of consensus guidelines published back in 2013 that provide a wonderful template for an exam answer even if they aren’t supported by the highest level evidence. If muscular tone is worsening things then get rid of it * optimise fluid resuscitation. So a few basics to start with. optimise perfusion.