Remove 2019 Remove Fluid Resuscitation Remove Shock
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ToxCard: Iron

EMDocs

Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. 6 Severe toxicity and shock are typically seen with serum iron concentrations above 500 g/dL and serum iron concentrations above 1000 g/dL are associated with significant mortality. McGraw Hill; 2019.

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Trauma Resuscitation Updates

RebelEM

I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. Clinical Take Home Point: In patients with TBI and hypovolemic shock, target a SBP or MAP ≥90mmHg, but know this is based on limited evidence. vs SBP target <90mmHg which resulted in a mortality of 33.4% NEJM 1994. [2] NEJM 1994. [2]

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Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

RebelEM

This systematic review and meta-analysis attempts to elucidate whether a more conservative fluid resuscitation approach is warranted in volume sensitive sepsis patients, such as those with congestive heart failure (CHF). Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Am J Emerg Med. 2023;73:34-39.

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IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

RebelEM

13 That is to say nothing of the effect that the type and response to shock has on the individual patients involved in these studies. Simply put, a difference greater than or equal to 12% between the largest and smallest pulse pressure can predict fluid responsiveness. Jan 2019; PMID: 30138573. Am J Respir Crit Care Med.

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Chemical Burns

Mind The Bleep

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications. 2019 Nov;34(4):276-281. Epub 2019 Nov 29.

Burns 52
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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. link] (2019).

Burns 97
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Electrical injuries

Don't Forget the Bubbles

Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)? Children, especially toddlers, may insert objects into outlets, leading to shocks or burns. Electrical devices used near water sources can cause severe shocks. Was the voltage high or low (as below)?

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