Pediatric EM Morsels

SEPTEMBER 22, 2023

While we may allow permissive hypotension in damage control resuscitation of hemorrhagic shock, in neurogenic shock you should maintain an age-appropriate blood pressure. McGraw Hill Education; 2019:104-109 Dave S, DAHLSTROM JJ. McGraw Hill Education; 2019:125-138 Ziu E, Mesfin FB. References Coleman-Satterfield, TT.

Shock 304

Shock Pediatrics Dislocations Hyperthermia / Hypothermia 304

PulmCCM

FEBRUARY 27, 2025

Balanced crystalloids are considered to be probably superior to normal saline as a resuscitation fluid in critically ill patients. Based on their similarities, you might expect no differences in outcomes between patients resuscitated with LR or Normosol-R. Buffering capacity (i.e., The strong ion difference of plasma is about 40 mEq/L.

Resuscitation 95

Resuscitation Outcomes Research 95

Dr. Smith's ECG Blog

JUNE 27, 2024

N Engl J Med [Internet] 2019;Available from: [link] Should all patients with shockable arrest be taken to angiography regardless of STEMI or No STEMI? Resuscitation Plus [Internet] 2020;4:100032. Lemkes JS, Janssens GN, van der Hoeven NW, et al. Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. As per Dr.

Resuscitation 113

Resuscitation EKG/ECG Outcomes Hospitals 113

Sensible Medicine

MARCH 14, 2025

The only problem was that the patient population would change over the course of the study – the unscreened population was studied mostly in 2019 and early 2020 while the screened population was mostly late 2020 early 2021. It looked like this: Ingenious, right? Thus, the results would have to be adjusted. to 0.3%).

Sepsis 103

Sepsis Wellness Documentation/Coding Fluid Resuscitation 103

Broome Docs

NOVEMBER 17, 2024

Resuscitation. Epub 2019 Dec 13. Resuscitation. Palatinus HN, Johnson MA, Wang HE, Hoareau GL, Youngquist ST. Early intramuscular adrenaline administration is associated with improved survival from out-of-hospital cardiac arrest. 2024 Aug;201:110266. doi: 10.1016/j.resuscitation.2024.110266. 2024.110266. Epub 2024 Jun 9.

Resuscitation 61

Resuscitation Administration Radiology Radiology 61

EMDocs

DECEMBER 6, 2024

Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Case Follow-up: The patient received a fluid resuscitation with 20 mL/kg bolus of normal saline. McGraw Hill; 2019. Basic assessment: airway, breathing, circulation. Antiemetics as needed. 2 L/hr in adults. References: Perrone J.

Poisoning 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

The Skeptics' Guide to EM

JUNE 15, 2024

Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. You initiate standard, simultaneous assessment and resuscitation following the Advanced Trauma Life Support (ATLS) principles. Reference: Jansen et al.

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Resuscitation Patient Safety Operations Emergency Department 120

The Trauma Pro

JUNE 18, 2024

Early resuscitation, particularly with blood products in patients with hemorrhage, is literally a lifesaver. To facilitate this, massive transfusion protocols (MTP) have been designed to rapidly deliver sizable quantities of blood products to the trauma resuscitation bay. Epub 2019 Nov 1. Bottom line: Hmm. J Pediatr Surg.

Pediatrics 113

Pediatrics Blood Transfusions Resuscitation Shock 113

RebelEM

NOVEMBER 30, 2023

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). Am J Emerg Med. 2023;73:34-39. What They Did: Researchers performed a systematic review and meta-analysis. Am J Emerg Med.

Sepsis 121

Sepsis Fluid Resuscitation Resuscitation Administration 121

Pediatric EM Morsels

JUNE 9, 2023

Of course, we all have a healthy respect for post-tonsillectomy hemorrhage and we like to talk about Damage Control Resuscitation. Specific Therapies for Variceal Hemorrhage : [ Luoto, 2020 ; Castillo, 2019; Garcia-Tsao, 2007 ] Antibiotic prophylaxis (usually for 7 days) Ceftriaxone is reasonable 1st choice. 2019 Jul;98(29):e16505.

Pediatrics 154

Pediatrics Head Injuries Airway Management Resuscitation 154

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. While you are leading the resuscitation, one of your senior colleagues belittles a junior staff member for struggling to site an IV line. Conclusion Critical care resuscitation is stressful.

Leadership 105

Leadership Resuscitation Teamwork Patient Safety 105

EMDocs

JUNE 25, 2024

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). IOs and central lines are also options.

Burns 97

Burns Fluid Resuscitation Resuscitation Poisoning 97

Mind The Bleep

OCTOBER 29, 2024

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

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

EMDocs

JUNE 22, 2024

Electronic address, p. “Amniotic fluid embolism: diagnosis and management.” ” Am J Obstet Gynecol 215(2): B16-24. link] j.ajog.2016.03.012 2016.03.012 Patel, P., “Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation.” ” Clin Appl Thromb Hemost 25: 1076029619843338.

EMS 111

EMS Resuscitation Blood Transfusions Seizures 111

RebelEM

FEBRUARY 8, 2024

were they in the resuscitative phase? were they in the resuscitative phase? This study does not address the utility of arterial lines vs NIBP in the acute resuscitative phase Author Conclusion: “There was broad agreement between IABP and NIBP in critically ill patients over a range of BPs and severity of illness. to 2.47; p – 0.04

Resuscitation 125

Resuscitation Outcomes EMS Sepsis 125

RebelEM

JUNE 26, 2023

Clinical Take Home Point: In adult patients with trauma at risk of massive transfusion, receiving standard trauma resuscitation management, the addition of 4F-PCC did not result in a decrease in blood product consumption over 24 hours compared to placebo. J Trauma Acute Care Surg 2019. Severe acute traumatic coagulopathy = PT >1.5

Administration 145

Administration Outcomes Resuscitation Radiology 145

EMDocs

JANUARY 16, 2024

Hypothermic Arrest In general, hypothermic patients in cardiac arrest should be aggressively resuscitated. Patients can have excellent outcomes despite prolonged resuscitation. 2,3 If the patient meets criteria for resuscitation, they generally are not declared dead until their core temperature is above 32℃ (“warm and dead”).

Hyperthermia / Hypothermia 109

Hyperthermia / Hypothermia Resuscitation CPR EMS 109

Don't Forget the Bubbles

AUGUST 23, 2023

These unprocessed emotions can lead to vicarious trauma , especially in resuscitation providers. Rather, immediately after an unsuccessful resuscitation attempt, there should be an opportunity for those involved to partake. Resuscitation. Przednowek, T. Spartan Medical Research Journal. Spencer, S.A.

Emergency Department 98

Emergency Department Resuscitation Documentation/Coding Best Practices 98

ACEP Now

NOVEMBER 7, 2024

This changed in 2019 when the American Red Cross rolled out a suite of courses that teach the same science and skills in a more learner-centered way. After three years of curriculum development and testing, the Red Cross launched a package of courses that includes BLS, ALS, and PALS training with certification in 2019.

Advances Cardiac Life Support (ACLS) 74

Advances Cardiac Life Support (ACLS) Military CPR Basic Life Support 74

RebelEM

FEBRUARY 24, 2025

Jan 2019; PMID: 30138573. lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial. Sep 2010; PMID: 20502865 Teboul JL, et al. Arterial Pulse Pressure Variation with Mechanical Ventilation. Am J Respir Crit Care Med. Castro R, et al.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

The Trauma Pro

SEPTEMBER 14, 2023

” This guideline was implemented in 2018-2019, and patients presenting before implementation were compared to those arriving after. Part of the resuscitation process for major trauma involves obtaining a chest X-ray. The 300cc threshold is determined by using Mergo’s formula for calculating the volume of a square prism.

Resuscitation 124

Resuscitation Hospitals Wellness 124

Don't Forget the Bubbles

MAY 10, 2023

Resuscitation is a team sport. Role stickers or role aprons with names on them are simple measures to highlight resuscitation roles. A study in Denmark in 2021 explored barriers to effective resuscitation in over 900 in-hospital resuscitations across six hospitals in Denmark. It was the most phenomenal resuscitation.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

Don't Forget the Bubbles

JUNE 30, 2023

Elsa was found face down in the family pool 20 minutes after last visual contact and was picked up without resuscitation. She was intubated at the scene and transported to your ED, with cardiopulmonary resuscitation (CPR) performed en route. Ann Cardiothorac Surg 2019; 8:137–142 But Elsa’s temperature is 30.1⁰C. and Schulze, C.,

Hyperthermia / Hypothermia 145

Hyperthermia / Hypothermia Military CPR EKG/ECG 145

RebelEM

NOVEMBER 20, 2023

Early expeditious definitive hemorrhage control is a major focus in trauma resuscitation. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial [published online ahead of print, 2023 Oct 12]. J Spec Oper Med.

Resuscitation 91

Resuscitation Operations Outcomes Hospitals 91

ALiEM

APRIL 12, 2023

Ever finally step away from a busy resuscitation and someone stops you for peripheral IV access? Egan, Pharmacology and Physiology for Anesthesia (Second Edition), Elsevier, 2019, Pages 390-411, ISBN 9780323481106. You set up everything, have the patient positioned, and then notice there is no sterile ultrasound gel. No problem.

Ultrasounds 103

Ultrasounds Emergency Department Resuscitation Wellness 103

Ken Grauer, MD

JUNE 6, 2023

He could not be resuscitated. The March 31, 2019 post in Dr. Smith's ECG Blog — My Comment ( at the bottom of the page ) illustrates the potentially misleading effect the pre-hospital ECG may have in patients with LVH ( ie, by cutting off S wave voltage in the anterior leads ).

EKG/ECG 195

EKG/ECG Hospitals Resuscitation Wellness 195

Don't Forget the Bubbles

JUNE 30, 2023

In addition, a flimsy cannula is easily dislodged during ongoing resuscitation and easily clots off. This was a randomised controlled multisite study comparing resuscitation of trauma patients requiring massive transfusion using either 1:1::1 or 1:1:2 ratios of platelets to plasma to red blood cells. to −0.5%]; P  = 0.03.).

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

The Skeptics' Guide to EM

MAY 25, 2019

Date: May 23rd, 2019 Reference: Joseph et al. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. JAMA Surgery March 2019. Date: May 23rd, 2019 Reference: Joseph et al. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma.

Military 52

Military Resuscitation PPE Emergency Department 52

EMDocs

AUGUST 22, 2023

2019 American Heart Association Focused Update on Advanced Cardiovascular Life Support: Use of Advanced Airways, Vasopressors, and Extracorporeal Cardiopulmonary Resuscitation During Cardiac Arrest: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

Emergency Department 94

Emergency Department Blood Transfusions Resuscitation Sepsis 94

RebelEM

MAY 18, 2023

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. Liberal: 14.9% Liberal: 14.9% Liberal: 14.9%

Sepsis 104

Sepsis Shock Resuscitation Outcomes 104

Dr. Smith's ECG Blog

AUGUST 2, 2024

Yet recognition of acute RV MI is extremely important clinically — because emergency treatment will often require different priorities (ie, avoidance of nitroglycerine; fluid resuscitation for hypotension ).

EKG/ECG 119

EKG/ECG Fluid Resuscitation Academics Resuscitation 119

Emergency Medicine Journal

MAY 23, 2023

Background Whether and how bystander cardiopulmonary resuscitation (CPR) modifies the cardiac rhythm after out-of-hospital cardiac arrest (OHCA) over time remains unclear. The first documented cardiac rhythm was compared between patients who received bystander CPR and those who did not, using a 1:2 propensity score-matched analysis.

Resuscitation 40

Resuscitation CPR Hospitals Documentation/Coding 40

RebelEM

SEPTEMBER 26, 2022

Hayes-Larson 2019). Rezaie, MD (Twitter: @srrezaie ) The post TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding appeared first on REBEL EM - Emergency Medicine Blog. Likewise, investigators also excluded patients on antiplatelets and anticoagulants, further limiting the generalizability of results.

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

Don't Forget the Bubbles

OCTOBER 7, 2024

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. Available from: [link] Part 8: Advanced Challenges in Resuscitation Section 3: Special Challenges in ECC. Resuscitation.

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

EMDocs

APRIL 10, 2024

2] Labs that may be useful after the initial resuscitation and for the admitting physician may include a basic metabolic panel and an arterial or venous blood gas analysis. [2] McGraw Hill Companies, Inc; 2019. doi:10.1136/bcr-2019-233119 Neal JM, Barrington MJ, Fettiplace MR, et al. The American Journal of Emergency Medicine.

Advances Cardiac Life Support (ACLS) 111

Advances Cardiac Life Support (ACLS) Seizures EMS Poisoning 111

EMDocs

SEPTEMBER 7, 2023

2,10 Initial stabilization of DEG toxicity includes correcting acid-base abnormalities, electrolyte abnormalities, and volume resuscitation. Volume resuscitation as needed while adjusting for any developing acute kidney injury. McGraw Hill, 2019. McGraw Hill, 2019. CDC’s Morbidity and Mortality Weekly Report.

Poisoning 92

Poisoning CDC Administration Emergency Department 92

RebelEM

MARCH 30, 2023

The TOMAHAWK (Desch 2021), COACT (Abella 2019), and PEARL (Lemkes 2019) trials examined patients with OHCA without ST elevation with a shockable rhythm, and investigators found no difference in delayed versus emergency angiogram. Article: How-Berlemont C, Lamhaut L, Diehl J, et al. Additionally, the trial had several biases.

Hospitals 66

Hospitals Outcomes EKG/ECG Resuscitation 66