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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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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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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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First10EM Journal Club: October 2022

Broome Docs

2018 Sep 11;362:k3843. PMID: 30206143 Less is more when it comes to intravenous fluids de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. Breaking good news: an essential skill for avoiding too much medicine? doi: 10.1136/bmj.k3843. N Engl J Med.

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Best Practices for Upper Gastrointestinal Hemorrhage

ACEP Now

Fluid resuscitation should be initiated. 13 A 2018 meta-analysis found that terlipressin is comparable with somatostatin, octreotide, and vasopressin in the control of bleeding. 14 In clinically stable patients who do not require resuscitation, EGD is less urgent and may be performed within six to 24 hours.

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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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Grand Rounds Recap 3.29.23

Taming the SRU

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9%