Remove 2017 Remove Blood Transfusions Remove Resuscitation
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Trauma Resuscitation Updates

RebelEM

Ann Emerg Med 2017 [6] This was a retrospective database review of 7521 traumatic brain injury patients SBP target ≥90mmHg resulted in a mortality of 7.8% Ann Emerg Med 2017 [6] This was a retrospective database review of 7521 traumatic brain injury patients SBP target ≥90mmHg resulted in a mortality of 7.8% NEJM 1994. [2] NEJM 1994.

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emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

EMDocs

Calcium and resuscitation Severely injured trauma patients are commonly hypocalcemic. Up to 56% have an ionized Ca < 1 mmol/L, and this increases mortality and need for transfusion. Transfusion induced hypoCa is common in patients undergoing massive transfusion. Transfusion-Related Hypocalcemia After Trauma.

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A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Don't Forget the Bubbles

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. Obviously, one also needs to address the cause of the shock, or any efforts in resuscitation will only bring a temporary improvement. He presented tachycardic and hypotensive with a capillary refill time of 5 seconds.

Shock 143
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TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

RebelEM

A meta-analysis of fifteen RCTs comparing blood product transfusion rates of cardiothoracic and surgery patients found significantly lower transfusion rates of FFP in TEG/ROTEM guided group compared to traditional tests, with no difference in survival rates (Fahrendorff 2017). Published 2017 Apr 13. 2017;25(1):39.

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Vasopressor Nonresponse

Northwestern EM Blog

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. There is a subset of patients who, despite aggressive conventional resuscitation, have an inadequate hemodynamic response and develop refractory shock. 2017; 45(9): 1443-1449.

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Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

The primary outcome was 30-day mortality with secondary outcomes looking at 24 hour in-hospital mortality, blood resuscitation at 6 and 24 hours, incidence of multiorgan failure, ARDS, nosocomial infection, early seizures, PE/DVT, crystalloid resuscitation after 24 hours, and the incidence of coagulopathy.

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Episode 21- Updates and Controversies in the Early Management of Sepsis and Septic Shock

EB Medicine

And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. Patient’s need adequate fluid resuscitation. Just a reminder that a history of CHF doesn’t preclude proper fluid resuscitation.

Sepsis 40