Don't Forget the Bubbles

NOVEMBER 27, 2023

What is Shock? Shock is defined as a type of circulatory failure where lack of oxygen leads to dysfunction of vital organs. There are many types of shock which may affect children, and management is specific to the type of shock. The overall goal in managing any cause of shock is to restore oxygen delivery to the organs.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

Mind The Bleep

DECEMBER 19, 2023

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. NaCl fluid bolus over 15 minutes. We do not subtract the bolus as the child was shocked.

Dehydration 98

Dehydration Fluid Resuscitation Shock Resuscitation 98

Taming the SRU

MAY 5, 2023

doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. 2021, Jarczak, Kluge et al. 2021, Im, Kang et al. 2021, Im, Kang et al. N Engl J Med. 2023;388(6):499-510. 2019, Bauer, Gerlach et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

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.

Pediatrics 105

Pediatrics Fluid Resuscitation Hospitals Research 105

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 ).

Operations 77

Operations EMS Fluid Resuscitation Resuscitation 77

RebelEM

MAY 25, 2023

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]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

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