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emDOCs Podcast – Episode 103: Thermal Burn Injury

EMDocs

Fluid resuscitation target and fluid Fluid resuscitation is one of the most important parts of management; goal is to increase intravascular volume and ensure end organ perfusion. Calculating fluid resuscitation: Parkland formula: 4 mL X % TBSA X weight in kilograms. Total amount over 24 hours.

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Diabetic Ketoacidosis in Paediatrics

Mind The Bleep

It is also vital to do a fluid balance assessment. Majority of DKA patients are in a fluid deficit and present acutely with shock. Therefore, they require fluid resuscitation to restore blood pressure, correct the ketonemia and electrolyte abnormalities, and oliguria. 2018, November ). References (2021).

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Electrical injuries

Don't Forget the Bubbles

Judicious fluid resuscitation is critical; patients may become volume-deplete due to fluid loss/oedema secondary to burns. Volume resuscitation in patients with high-voltage electrical injuries. Deep tissue injuries may not be visible, and as muscle breaks down, it leads to myoglobinuria, rhabdomyolysis and renal failure.

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EM@3AM: Stercoral Colitis

EMDocs

If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. Pediatric Emergency Care 34(9):p e159-e160, September 2018. | Fecal Impaction and Nonperforated Stercoral Colitis: Red Flags for Poor Outcomes. Cureus, 15(7), e41705.

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Major Trauma – Injuries by Assault

Don't Forget the Bubbles

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation.

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IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

RebelEM

J Invest Surg Sept 2018; PMID: 28952826 Robb J. lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial. .” Anaesthesia, Pain, Intensive Care and Emergency MedicineAPICE: Oct 1005; PMID: 16356246 Bilgili B, et al.

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SGEM#207: Ahh (Don’t) Push It – Pre-Hospital IV Antibiotics for Sepsis.

The Skeptics' Guide to EM

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

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