The Skeptics' Guide to EM

FEBRUARY 17, 2018

The Lancet Nov 2017. The Lancet Nov 2017. The Lancet Nov 2017. Intervention: Ceftriaxone 2g IV * Control: Usual care (fluid resuscitation and supplementary oxygen) * Outcome: * Primary: All-cause mortality at 28 days . [display_podcast] Date: February 14th, 2018 Reference: Alam N et al. Reference: Alam N et al.

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

Mind The Bleep

MAY 12, 2023

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. GBD 2017 Cirrhosis Collaborators. On Day 3 (i.e. On Day 3 (i.e. Bull World Health Organ.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

EMDocs

JULY 17, 2023

Measures to optimize the patient for surgical intervention and treat shock, including antibiotics and fluid resuscitation, are associated with improved outcomes in these patients. 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation. Cancers (Basel ). 2021;13(9):2025. Published 2021 Apr 22.

Operations 77

Operations EMS Fluid Resuscitation Resuscitation 77

Northwestern EM Blog

FEBRUARY 14, 2022

The ATHOS-3 trial in 2017 explored the efficacy of angiotensin II as a vasopressor for severe vasodilatory shock. Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

ACEP Now

OCTOBER 11, 2024

Fluid resuscitation will likely be warranted, and with crystalloid solution is most appropriate. A pediatric submersion score was developed and validated in 2017 identifying five factors that, if present, suggest safe discharge from the ED after an eight-hour observation period.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

ACEP Now

MARCH 14, 2024

Treatment for burns should focus on fluid resuscitation as appropriate based on your institution’s burn protocol per Brooke, Parkland, Rule of 10s etc. Lastly, vessels can be damaged by internal burns, which may lead to poor perfusion and delayed complications as thrombosis or third spacing. McGraw Hill; 2016. Electrical injuries.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. However, a 2017 study of 34 patients suggests that balloon tamponade, when used as a bridge to EGD, improves patient mortality, with 59 percent of patients surviving to hospital discharge. Patients should be assessed for evidence of hypovolemia or active exsanguination.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

EMDocs

JUNE 27, 2024

2017 Dec 1;30(4):191-201. -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 4 mg per dose q20-30min) or hydromorphone (0.01-0.02

Pediatrics 75

Pediatrics Dehydration EMS Hospitals 75

Don't Forget the Bubbles

MARCH 18, 2024

She receives fluid resuscitation, and you organise some tests to find out why she is so tired. 2017 Sep 12 [cited 2023 Nov 30];archdischild-2016-311377. 4-year-old Stephanie presents with vomiting, diarrhoea, and lethargy. She appears pale and dehydrated , and her level of alertness fluctuates. F1000Research. 2019 Sep 25;8:1690.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Taming the SRU

MAY 5, 2023

Respiratory failure and more severe acute kidney injury were demonstrated to be more common in patients who received higher volumes of intravenous fluid (Andrews, Muchemwa et al. 2017, Silversides, Major et al. Bernard (2017). Evaluation and Predictors of Fluid Resuscitation in Patients With Severe Sepsis and Septic Shock."

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Don't Forget the Bubbles

JUNE 10, 2024

Initial Management Supportive Care : Initial management involves stabilising the infant, which includes fluid resuscitation, cessation of enteral feeds, and provision of total parenteral nutrition (TPN) to rest the bowel and meet the nutritional needs of the infant. How do you treat necrotising enterocolitis? ANZNN Annual Report.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Don't Forget the Bubbles

NOVEMBER 18, 2024

Before considering fluid resuscitation or inotropes, it is essential to correct the infant’s body temperature. Effective management of MAS will often result in the stabilization of blood pressure. Hypothermia: Newborns, particularly preterm infants, are prone to hypothermia. Patel, A., & Fanaroff, J. El-Khuffash, A.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

EB Medicine

OCTOBER 1, 2018

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. Let’s start with fluids. Patient’s need adequate fluid resuscitation. So quite a few changes!

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

OCTOBER 5, 2024

4 The incidence of ESBL-E identified in bacterial cultures in the United States increased by 53% from 2012 to 2017. Management 9-12 Patients such receive standard resuscitation care including: Antipyretics such as Tylenol (650-1000 mg PO), Ibuprofen (600 mg PO), or Toradol (15mg IV). IV fluid resuscitation as needed.

EMS 74

EMS Infectious Diseases Sepsis Hospitals 74

EMDocs

MARCH 11, 2024

Patients who cannot tolerate oral intake of fluids should receive intravenous (IV) fluid resuscitation but are encouraged to start drinking ORS as soon as they are able. Cholera vaccines: WHO position paper – August 2017. Published online August 25, 2017. Crosstalks Between Gut Microbiota and Vibrio Cholerae.

Dehydration 90

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 90

EMDocs

DECEMBER 16, 2023

Temps greater than 41.5C per minute) 1,4 Body bag may be utilized if no immersion tank available 3 Evaporative cooling (DT 0.1C The New England journal of medicine , 352 (11), 1112–1120. link] Chava, R., Raghavan, M. Halperin, H., Maqbool, F., Geocadin, R., Quinones-Hinojosa, A., Kolandaivelu, A., A., & Tandri, H. link] Chava, R., 27(5), 634.e1–634.e3.

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68