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emDOCs Podcast – Episode 93: BRASH Syndrome

EMDocs

Episode 93: BRASH syndrome Background: Brash syndrome has 5 components: bradycardia, renal failure, AV nodal blocker, shock, hyperkalemia. An inciting event will typically push them over the edge into BRASH syndrome: Dehydration Hypotension from sepsis or another condition GI illness Dosage increase of a chronic medication (e.g.,

Shock 87
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emDOCs Revamp – Acute Chest Syndrome

EMDocs

2016 Dec;91(12):1185-1190. Epub 2016 Oct 3. 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 Am J Hematol.

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Episode 36 - Diagnosis and Management of Acute Gastroenteritis in the Emergency Department

EB Medicine

No 1996 AAP guidelines, 2016 ACG guidelines, and 2017 IDSA guidelines all note diarrhea illness but may be vomiting predominant. Laboratory Testing and Imaging: Dehydration is the biggest contributor to mortality, especially in the very young and elderly. Lab evaluation for dehydration is recommended in these populations.

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Are we on the right TRACT? 

Don't Forget the Bubbles

These were presented as hazard ratios and included fever at presentation, previous transfusion ever, haemoglobinuria, malaria, sickle cell disease on enrolment, HIV, evidence of sepsis, malnutrition, shock, hypothermia, and dehydration. 2016 Jan 7;4(1). Were the study groups similar at the start of the trial? N Engl J Med.

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Episode 30 - Emergency Department Management of Patients With Complications of Bariatric Surgery

EB Medicine

While it was < 15% in 1990, by 2016 it reached 40%. Consider IV access and early IV fluids in those at risk for dehydration and intra-abdominal infections. Jeff: Tachycardic patients should make you concerned for hypovolemia 2/2 dehydration, sepsis, leaks, and blood loss. Jeff: Well that’s kind worrisome. million adults!!

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Episode 19 - Cannabinoids: Emerging Evidence in Use and Abuse

EB Medicine

Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 Jeff: The hyperemetic phase lasts 24-48 hours and can lead to dehydration, electrolyte abnormalities, and weight loss. Be sure to look for and treat dehydration, acute renal failure, and rhabdo though. Subst Abus.

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EM@3AM: Hyperthermia

EMDocs

Heat stroke can lead to end-organ dysfunction such as rhabdomyolysis, disseminated intravascular coagulation, cardiogenic shock, liver failure, and cerebral edema. Broad-spectrum antibiotics (A) for septic shock are not inappropriate given the hyperthermia, tachycardia, and hypotension. Temps greater than 41.5C