2021, Fluid Resuscitation and Outcomes

2021

Fluid Resuscitation

Outcomes

Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

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. Cross-validation was performed.

Fluid Resuscitation

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes

Trauma Resuscitation Updates

RebelEM

MAY 25, 2023

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. NEJM 1994. [2] NEJM 1994. [2]

Resuscitation

Resuscitation Fluid Resuscitation Head Injuries Shock

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Ken Grauer, MD

The SQuID Protocol: SQ Insulin in DKA?

RebelEM

OCTOBER 2, 2023

Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 tests/hr (0.8 Traditional: 1.0 tests/hr (0.8 Pre-Intervention: 1.0

Operations

Operations Academics Outcomes Fluid Resuscitation

Less is More. Again: Speed of IV Fluid Administration in Pancreatitis (WATERFALL Trial)

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

Administration Fluid Resuscitation Resuscitation Outcomes

A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Don't Forget the Bubbles

NOVEMBER 27, 2023

So, fluid has been tried but has not got close to fixing the problem. In middle-to-high-income countries, after 40-60ml/kg of fluid resuscitation, the Surviving Sepsis Campaign International Guidelines recommend using vasoactive drugs. Published 2021 Apr 16. What are vasoactive drugs? Ed makes a full recovery.

Shock

Shock Sepsis Fluid Resuscitation Resuscitation

emDOCs Revamp – Acute Chest Syndrome

EMDocs

JUNE 27, 2024

Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. 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.

Pediatrics

Pediatrics Dehydration EMS Hospitals

Large bowel obstruction: ED presentation, evaluation, and management

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. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. Published 2021 Apr 22. Cancers (Basel ).

Operations

Operations EMS Fluid Resuscitation Resuscitation

The CLOVERS Trial

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. N Engl J Med. 2023;388(6):499-510. 2019, Bauer, Gerlach et al.

Sepsis

Sepsis Shock Administration Resuscitation

Best Practices for Upper Gastrointestinal Hemorrhage

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. There are few data on the outcomes of UGIB when balloon tamponade is used as a temporizing measure. Outcomes in variceal hemorrhage following the use of a balloon tamponade device. Sleep well, endoscopist: January 2021 Annals of Emergency Medicine journal club.

Best Practices

Best Practices Resuscitation Fluid Resuscitation Outcomes

Neonatal Hypotension

Don't Forget the Bubbles

NOVEMBER 18, 2024

Research and guidelines from Australian centres, like those published by the Australian and New Zealand Neonatal Network (ANZNN), emphasize early detection and management to improve outcomes. Before considering fluid resuscitation or inotropes, it is essential to correct the infant’s body temperature. and Roberts, N.

Sepsis

Sepsis Shock Hyperthermia / Hypothermia Administration

Haemolytic Uraemic Syndrome

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]. Early Volume Expansion and Outcomes of Hemolytic Uremic Syndrome. Treatment and outcome of Shiga-toxin-associated hemolytic uremic syndrome (HUS). She is apyrexial, tachycardic and normotensive.

Dehydration

Dehydration Infectious Diseases Seizures Pediatrics

Sepsis Updates Relevant to the Emergency Physician

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

Sepsis Fluid Resuscitation Resuscitation Shock

Paediatric IV Fluid Prescribing

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. Boluses were given in 20-40ml/kg aliquots.

Fluid Resuscitation

Fluid Resuscitation Hospitals Dehydration Research

EM@3AM: Hyperthermia

EMDocs

DECEMBER 16, 2023

Clinical characteristics and outcome of thyroid storm: a case series and review of neuropsychiatric derangements in thyrotoxicosis. Outcome and risk factors associated with extent of central nervous system injury due to exertional heat stroke. Temps greater than 41.5C BMC research notes , 8 , 758. link] Swee, duS., L., & Lim, A.

Hyperthermia / Hypothermia

Hyperthermia / Hypothermia EMS Stroke Seizures

Emergency Care Today

Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

Trauma Resuscitation Updates

Trending Sources

The SQuID Protocol: SQ Insulin in DKA?

Less is More. Again: Speed of IV Fluid Administration in Pancreatitis (WATERFALL Trial)

A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

emDOCs Revamp – Acute Chest Syndrome

Large bowel obstruction: ED presentation, evaluation, and management

The CLOVERS Trial

Best Practices for Upper Gastrointestinal Hemorrhage

Neonatal Hypotension

Haemolytic Uraemic Syndrome

Sepsis Updates Relevant to the Emergency Physician

Paediatric IV Fluid Prescribing

EM@3AM: Hyperthermia

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