Mind The Bleep

DECEMBER 19, 2023

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. References (2021). Diabetic Ketoacidosis.

Dehydration 98

Dehydration Fluid Resuscitation Shock Resuscitation 98

RebelEM

SEPTEMBER 29, 2022

There are also potential harms to large volume fluid resuscitation including progression of pancreatitis and fluid overload with or without respiratory failure. Though the initial recommendation for aggressive fluid resuscitation was not based on substantial evidence, clinicians have been slow to pivot away from this approach.

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

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 103

Operations Academics Fluid Resuscitation Outcomes 103

Broome Docs

OCTOBER 31, 2022

Epub 2021 Dec 14. 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. PMID: 36103415 Bottom line: Less is more when it comes to intravenous fluids. 2022 Jul 26:emermed-2021-211540.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

Mind The Bleep

FEBRUARY 27, 2024

There could be any number of reasons for this but some examples are: they have severe D&V and aren’t keeping fluids down, or because they are pre or post-op, or have presented very unwell and need fluid resuscitation. saline + 5% dextrose or plasma-lyte 148 + 5% dextrose. .

Fluid Resuscitation 96

Fluid Resuscitation Hospitals Dehydration Research 96

Emergency Medicine Cases

MARCH 1, 2022

In this month's EM Quick Hits podcast: Brit Long on Surving Sepsis Campaign -2021 Updates, Nour Khatib on rural medicine case - angle closure glaucoma, Reuben Strayer on bougie vs endotracheal tube and stylet on first-attempt intubation, Justin Hensley on management of frostbite, Sarah Foohey on the hot and altered patient, and Andrew Petrosoniak on (..)

Sepsis 52

Sepsis EMS Fluid Resuscitation Hyperthermia / Hypothermia 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. 2021 Jan;70(1):9-29. On Day 3 (i.e. 48 hours later) albumin is administered at 1g/kg.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

Taming the SRU

MAY 5, 2023

2021, Jarczak, Kluge et al. 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. 2021, Im, Kang et al. Levy (2021). Nierhaus (2021). N Engl J Med.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. Sleep well, endoscopist: January 2021 Annals of Emergency Medicine journal club. Patients should be assessed for evidence of hypovolemia or active exsanguination. Initial laboratory studies should include CBC, complete metabolic profile, blood type and screening, and coagulation studies.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 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. 2021 [cited 2023 Nov 30]. 4-year-old Stephanie presents with vomiting, diarrhoea, and lethargy. She appears pale and dehydrated , and her level of alertness fluctuates. She is apyrexial, tachycardic and normotensive. Rch.org.au.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Dr. Smith's ECG Blog

MAY 5, 2022

Fluid resuscitation was initiated. The November 27, 2021 post ( LA-RA reversal ). He denied any chest pain or shortness of breath and stated he felt at his baseline yesterday prior to drug use. On arrival in the ED, he was hypotensive with a systolic blood pressure in the 70s. Here is the initial ED ECG: What do you think?

EKG/ECG 52

EKG/ECG Fluid Resuscitation EMS Shock 52

EMDocs

DECEMBER 18, 2023

The most recent surviving sepsis campaign (SSC) guidelines were released in 2021, which provided 93 recommendations for evidence-based sepsis management. 1 Since 2021, attempts to identify a single screening tool with optimal sensitivity and specificity to predict which patients will develop sepsis or septic shock have been ongoing.

Sepsis 93

Sepsis Fluid Resuscitation Resuscitation Shock 93

EMDocs

JULY 17, 2023

Measures to optimize the patient for surgical intervention and treat shock, including antibiotics and fluid resuscitation, are associated with improved outcomes in these patients. Published 2021 Apr 22. 5 Non-perforated obstruction due to malignancy will usually be managed with urgent surgery. Cancers (Basel ). 2021;13(9):2025.

Operations 98

Operations EMS Fluid Resuscitation Resuscitation 98

EMDocs

DECEMBER 16, 2023

Temps greater than 41.5C per minute) 1,4 Body bag may be utilized if no immersion tank available 3 Evaporative cooling (DT 0.1C C., & Mathai, D. Predictors of multi-organ dysfunction in heatstroke. Emergency medicine journal : EMJ , 22 (3), 185–187. link] Jang, S. H., & Seo, Y. Medicine , 100 (13), e24053. Autonomic Dysfunction.

Hyperthermia / Hypothermia 96

Hyperthermia / Hypothermia EMS Stroke Seizures 96

Intensive Blog

FEBRUARY 9, 2023

Vasopressors such as noradrenaline are often required (systemic vasodilation is common in hepatic failure). link] [Accessed 10February 2023] Austin Clinical Toxicology Service. Amanita phalloides (Death Cap) and other Cyclopeptide Mushrooms [link] Austin Health Clinical Toxicology Service. Silibinin [link] Warrillow, S. Bellomo, R. 2014, Jan).

Poisoning 52

Poisoning Hyperthermia / Hypothermia Fluid Resuscitation Resuscitation 52

EMDocs

JUNE 27, 2024

Fluid overload due to intravenous fluid therapy for vaso-occlusive crisis in sickle cell disease: incidence and risk factors. 2021 Sep;194(5):899-907. Epub 2021 Jul 15. -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

Pediatrics 98

Pediatrics Dehydration EMS Hospitals 98

RebelEM

DECEMBER 23, 2024

Within this population, over 90% of healthcare encounters are due to painful vaso-occlusive episodes (VOE) ( Kidwell 2021 ). VOE is often complicated by hypovolemia, making fluid administration a common intervention ( Lovett 2017 ). Lactated Ringer (LR) and 0.9% JAMA Intern Med. 2024;184(11):1365-1372.

Fluid Resuscitation 128

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 128

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. For patients without frank signs of shock, it is reasonable to trial oral hydration prior to moving on to IV fluids.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

FEBRUARY 17, 2025

Aiming for zero fluid accumulation: First, do no harm. Anaesthesiol Intensive Ther, 2021. Pudjiadi, Inferior Vena Cava/Abdominal Aorta Ratio as a Guide for Fluid Resuscitation. J Emerg Trauma Shock, 2021. J Ultrasound Med, 2023. Perez Nieto, O.R., Prager, R., Can J Anaesth, 2024. Kusumastuti, N.P., Latief, and A.H.

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78

Don't Forget the Bubbles

JULY 3, 2024

Infant Deaths After Texas’ 2021 Ban on Abortion in Early Pregnancy. Fluid resuscitation in children with severe infection and septic shock: a systematic review and meta-analysis. Pediatr Infect Dis J. 2024 Jun 26. Risk Factors for Persistent Staphylococcus aureus Bacteremia in Children. Thornley EM, et al. 2024 Jun 21.

Pediatrics 105

Pediatrics Fluid Resuscitation Research Hospitals 105

Don't Forget the Bubbles

NOVEMBER 18, 2024

Before considering fluid resuscitation or inotropes, it is essential to correct the infant’s body temperature. Effective management of MAS will often result in the stabilization of blood pressure. Hypothermia: Newborns, particularly preterm infants, are prone to hypothermia. L., & Carcillo, J. R., & Bhattacharya, S.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

EMDocs

MARCH 11, 2024

Published online October 20, 2021. link] If ORS powder is not available but patients are able to tolerate oral fluid intake an ORS substitute can be made by adding 6 teaspoons of table sugar and 1/2 teaspoon of table salt (iodinated preferable) to each liter of water. Source: Centers for Disease Control and Prevention (U.S.).

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111