RebelEM

FEBRUARY 24, 2025

lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial. Nov 2020; PMID: 33140173 Hanson J, et al. Jan 2019; PMID: 30138573. Castro R, et al. Effects of capillary refill time-vs. Ann Intensive Care.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. Obviously, one also needs to address the cause of the shock, or any efforts in resuscitation will only bring a temporary improvement. So, fluid has been tried but has not got close to fixing the problem. 2021;25(1):146.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

EMDocs

MAY 15, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Hypervolemia – leads to pulmonary edema: Consider diuresis If euvolemic – start maintenance fluids of D5 in 0.45%NS American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support.

Blood Transfusions 103

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 103

EMDocs

MAY 28, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. If euvolemic – start maintenance fluids of D5 in 0.45%NS American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support. Published 2020 Feb 12. times maintenance. 2020;4(2):327-355.

Blood Transfusions 97

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

RebelEM

OCTOBER 2, 2023

Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. However, it is unclear if all degrees (mild, moderate, severe) of DKA require the same intensive treatment. tests/hr (0.8 Traditional: 1.0 tests/hr (0.8 Pre-Intervention: 1.0 tests/hr (0.9 Pre-COVID: 1.0

Operations 104

Operations Academics Fluid 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

EMDocs

NOVEMBER 1, 2023

6 Treatment : Airway Definitive airway management should be performed in those with respiratory distress with attention to appropriate resuscitation started beforehand in the setting of potential distributive shock from mediastinitis. 4 Fluid resuscitation and vasopressor use as appropriate. McGraw-Hill Education; 2020.

Operations 93

Operations Radiology Radiology Fluid Resuscitation 93

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. Stable Patients For both stable and resuscitated patients, high-dose IV proton pump inhibitor therapy (i.e., 14 In clinically stable patients who do not require resuscitation, EGD is less urgent and may be performed within six to 24 hours. 2020:395(10241):1927-1936.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

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. 2020 Mar;5(3):245-66. doi: 10.1136/gutjnl-2020-321790. Epub 2020 Oct 16.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

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. Cited June 2020]; 4 (11): 1261-1287. Cited June 2020]; Available from: [link] Hughes D. Cited June 2020]; Available from: [link] Balestracci A et al. Cited June 2020];27: 1407-1410. Cited June 2020]; 23: 1749-1760.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Northwestern EM Blog

FEBRUARY 14, 2022

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. Published online October 21, 2020. Two classes of vasopressors have been used in the past for hypotension. 2021;159(2):596-605. doi:10.1016/j.chest.2020.08.2074

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

Taming the SRU

MAY 5, 2023

Despite the complexity and heterogeneity of patients with sepsis, there have been few interventions which have been demonstrated to decrease mortality: early antimicrobial and fluid administration (Levy, Evans et al. Adam (2020). 2019, Bauer, Gerlach et al. 2018, Kuttab, Lykins et al. 2019, Evans, Rhodes et al. 2021, Im, Kang et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Mind The Bleep

FEBRUARY 9, 2024

Because she would not be for intubation, they discuss resuscitation status because, naturally, care during- and post-arrest would involve airway support. They agree this patient should be for full resuscitation and any other organ support he may require. The patient and team agree to instate a u-DNACPR. ABC of intensive care.

Hospitals 52

Hospitals Resuscitation Fluid Resuscitation Shock 52

Dr. Smith's ECG Blog

MAY 5, 2022

Fluid resuscitation was initiated. The February 11, 2020 post ( LA-RA reversal ). The March 18, 2020 post ( LA-RA reversal ). The August 28, 2020 post ( LA-LL reversal ). The November 19, 2020 post ( LA-LL reversal ). On arrival in the ED, he was hypotensive with a systolic blood pressure in the 70s.

EKG/ECG 52

EKG/ECG Fluid Resuscitation EMS Shock 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

Taming the SRU

MARCH 31, 2023

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed. As with soldiers in war, we know that as soon as we stop doing, we will start feeling.”

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

EMDocs

JANUARY 20, 2024

This patient’s recent diarrheal illness raises suspicion for hypovolemia, which would be treated with fluid resuscitation (D) , but her moist oral mucosa and dilated inferior vena cava suggest an eu- or hypervolemic state. Additional fluids will not improve her condition and may worsen it. 2020 Apr;7(2):400-406.

EMS 101

EMS Fluid Resuscitation Shock EKG/ECG 101

EMDocs

DECEMBER 16, 2023

Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. Ice water immersion and iced peritoneal lavage are additional methods used to lower temperature but are more invasive or can prevent additional resuscitative efforts.

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

Intensive Blog

FEBRUARY 9, 2023

Alexander, G. Hayllar, K. M., & Williams, R. 1989, Aug). Early indicators of prognosis in fulminant hepatic failure. Gastroenterology, 97 (2), 439-445. link] Nickson, C. Mushroom toxicity. Available from URL: [link] [Accessed 10 February 2023] Death Cap – Amanita phalloides. Royal Botanical Gardens Victoria. link] Berger, K. Bellomo, R.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Fluid Resuscitation Resuscitation 52

EMDocs

JUNE 27, 2024

2020 Feb 12;10(1):2470. -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 97

Pediatrics Dehydration EMS Hospitals 97

RebelEM

DECEMBER 23, 2024

VOE is often complicated by hypovolemia, making fluid administration a common intervention ( Lovett 2017 ). saline (NS) solutions are both isotonic crystalloids widely used for intravenous fluid resuscitation across many contexts and disease states ( Myburgh 2013 ). Lactated Ringer (LR) and 0.9% JAMA Intern Med.

Fluid Resuscitation 129

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 129

EMDocs

JULY 19, 2023

8 As always, remember to correct electrolyte abnormalities and provide fluid resuscitation as indicated. 2020 Aug 15;417:213343. Epub 2020 May 7. link] Ajsuvakova OP, Tinkov AA, Aschner M, Rocha JBT, Michalke B, Skalnaya MG, Skalny AV, Butnariu M, Dadar M, Sarac I, Aaseth J, Bjørklund G. Coord Chem Rev. 2020.213343.

Poisoning 92

Poisoning Fluid Resuscitation Administration Seizures 92

EMDocs

JANUARY 20, 2025

Sepsis There has been much controversy over the last two decades around the various nuances of volume resuscitation in ED patients with suspected sepsis, much of which goes beyond the scope of this limited review. In lower-resource settings, the evidence is stronger against a liberal approach to volume resuscitation. Andrews et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

FEBRUARY 17, 2025

He has had some additional episodes of hypotension post-intubation, which is treated with further volume resuscitation. Before considering a further fluid bolus, you do a point-of-care ultrasound (POCUS). Watching these signs, you pause he’s had 60ml/kg as fluid boluses, but what do you do with these signs? Bhardwaj, V.,

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78

Taming the SRU

MARCH 3, 2025

million fires in 2020, with some studies quoting over 500,000 emergency room visits annually for burn and inhalation injuries (4). Because inhalational injuries often co-occur with large cutaneous burns, aggressive fluid resuscitation can rapidly worsen upper airway edema making airway management especially challenging.

Burns 52

Burns Fluid Resuscitation Emergency Department Resuscitation 52

Taming the SRU

FEBRUARY 3, 2025

Additional Treatments for Severe Electrolyte Derangements Severe Hyperuricemia If uric acid 8 mg/dL or 25% increase from baseline develops, then rasburicase should be administered in addition to IV fluid resuscitation. McGraw-Hill Education; 2020:962-963. original document created by author of post. Accessed January 21, 2025.

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56