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Maintenance Fluids in Critical Illness

Don't Forget the Bubbles

In a PICU setting, sodium can come from various sources (resuscitation fluids, IV drugs and infusions, enteral feed), not just the maintenance fluids we prescribe. There is growing interest in giving no maintenance fluid and using the input from drug infusions and resuscitative boluses only. Most drugs are chosen to be dissolved in 0.9%

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Haemolytic Uraemic Syndrome

Don't Forget the Bubbles

She appears pale and dehydrated , and her level of alertness fluctuates. She receives fluid resuscitation, and you organise some tests to find out why she is so tired. Pay specific attention to fluid status, looking for evidence of dehydration. Manage hydration Children may be dehydrated or present with signs of fluid overload.

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

2015 May;169(4):492-505. Epub 2015 Mar 30. smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 mg/kg, max 0.4 C or 100.4

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Orofacial Infections

Mind The Bleep

2015) ‘Emergency Department’, in On-call in Oral and Maxillofacial Surgery. Written by Dr Ruby Fussell BDS MFDS(Ed)

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Managing a patient with decompensated liver cirrhosis

Mind The Bleep

9 There is no role for Tranexamic acid in upper GI bleeding and its use is harmful to patients 11 Escalate to a senior early for consideration of a higher level of care Refer for early endoscopy after resuscitation with haemodynamic stability. On Day 3 (i.e. 48 hours later) albumin is administered at 1g/kg. On Day 3 (i.e. 2021 Jan;70(1):9-29.

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Grand Rounds Recap 3.15.23

Taming the SRU

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.

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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

In addition, the patient received 750 mL of fluid resuscitation with transient improvement of blood pressure. As with other cases of shock, initial fluid resuscitation may be considered. For instance: sepsis, bleeding, dehydration, hypoxia, and mild ACS. 2015 Oct; 66(4):355-362. Annals of Emergency Medicine.

EKG/ECG 40