Remove 2013 Remove Operations Remove Shock
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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. Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. link] Chakravartty, S.,

EMS 98
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Single ventricle defects and the hunt for the best shunt

Don't Forget the Bubbles

But, they may present postnatally with cyanosis/hypoxaemia due to insufficient pulmonary blood flow, cardiogenic shock due to insufficient systemic blood flow, or both. Whilst waiting for an operation, they need to be managed medically. Soon after the operation, the baby is noted to have junctional ectopic tachycardia (JET).

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Vasopressors in Trauma

PHEM Cast

Further reading Matt has kindly provided a list of references from his Trauma Care talk which this podcast is based on: Peri-operative and critical care management of the brain – current evidence. Anaesthesia: Vol 77, No S1.

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REBEL Core Cast 94.0 – SBO

RebelEM

Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43

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Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

RebelEM

Point-of-care ultrasound (PoCUS) is inherently operator-dependent, which may have led to inconsistencies in the quality and findings of the ultrasound exams across different operators. R I Med J (2013). POCUS in dyspnea, nontraumatic hypotension, and shock; a systematic review of existing evidence. Emerg Med J.

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Diagnostics and Therapeutics: Arterial Lines and Invasive Blood Pressure Monitoring

Taming the SRU

A recent observational study was performed to pragmatically assess clinically meaningful differences in BP in a diverse critically ill cohort with shock. In general, radial artery readings in patients with shock likely underestimate central pressure which can lead to increasing vasopressor dosing. PMID: 35338337. Keville, M.

Shock 59
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Diagnostics: Inflammatory Markers

Taming the SRU

Similarly, a 2013 meta-analysis of 6 studies with 1,006 patients published in the American Journal of Emergency Medicine showed neither CRP nor PCT are sufficient to rule-in or rule-out infective endocarditis, with PCT having a pooled sensitivity of 64% and specificity of 73% and CRP having a pooled sensitivity of 75% and specificity of 73% [40].