2021, Fluid Resuscitation and Wellness

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.

Fluid Resuscitation

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes

Trauma Resuscitation Updates

RebelEM

MAY 25, 2023

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. Hypotensive resuscitation during active hemorrhage: impact on in-hospital mortality. Anesth Analg 2021. NEJM 1994. [2] NEJM 1994. [2]

Resuscitation

Resuscitation Fluid Resuscitation Head Injuries Shock

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

Don't Forget the Bubbles

NOVEMBER 27, 2023

And lastly, it’s actually quite hard to see how well the cardiovascular system is working, and this is one of its measurable features. This works well for a while, but eventually, the heart beats too fast to fill adequately. So, fluid has been tried but has not got close to fixing the problem. Published 2021 Apr 16.

Shock

Shock Sepsis Fluid Resuscitation 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

EM@3AM: Leukopenia

EMDocs

JANUARY 25, 2025

Well keep it short, while you keep that EM brain sharp. A previously healthy 23-year-old male with no medical or surgical history presents to the ED with generalized malaise and no energy, progressively getting worse over the last six weeks. 10^9/L) Moderate (0.50.9 10^9/L) Severe (< 0.5 10^9/L) Generalized leukopenia (i.e.

EMS

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation

EM@3AM: Stercoral Colitis

EMDocs

JANUARY 11, 2025

Well keep it short, while you keep that EM brain sharp. If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. Cureus 15(5): e39179.

EMS

EMS Sepsis Shock Fluid Resuscitation

Best Practices for Upper Gastrointestinal Hemorrhage

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. Hemoglobin takes several hours to reflect blood loss and should not be used as the sole indicator of bleeding severity.

Best Practices

Best Practices Resuscitation Fluid Resuscitation Outcomes

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

Neonatal Hypotension

Don't Forget the Bubbles

NOVEMBER 18, 2024

However, if the infant is well-perfused, cardiovascularly stable, and showing no signs of organ dysfunction, active treatment may not be necessary. Before considering fluid resuscitation or inotropes, it is essential to correct the infant’s body temperature. This can manifest as hypotension. L., & Carcillo, J.

Sepsis

Sepsis Shock Hyperthermia / Hypothermia Administration

emDOCs Revamp – Acute Chest Syndrome

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. 2021 Sep;194(5):899-907. Epub 2021 Jul 15. C or 100.4 mg/kg, max 0.4

Pediatrics

Pediatrics Dehydration EMS Hospitals

Bubble Wrap PLUS – July 2024

Don't Forget the Bubbles

JULY 3, 2024

In this month’s issue of Pediatrics, Brewster and colleagues investigated how well Google Translate and ChatGPT perform in translating discharge instructions. Infant Deaths After Texas’ 2021 Ban on Abortion in Early Pregnancy. Pediatr Infect Dis J. 2024 Jun 26. Thornley EM, et al. Pediatr Infect Dis J. 2024 Jun 21. JAMA Pediatr.

Pediatrics

Pediatrics Fluid Resuscitation Research Hospitals

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

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. They will want daily weights and closely monitored fluid balance.

Fluid Resuscitation

Fluid Resuscitation Hospitals Dehydration Research

Cholera: ED presentation, evaluation, and management

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

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation

IV fluids in the ED: When do we really need them?

EMDocs

JANUARY 20, 2025

1,2 For hypervolemia in heart failure patients, orthopnea >2 pillows is the most reliable clinical finding, 3,4 though an increase in peripheral edema and increased weight can be useful as well. 6-8 In patients who are on long-term hemodialysis, typical non-invasive signs of volume assessment seem to be unreliable as well.

Dehydration

Dehydration Fluid Resuscitation Sepsis Resuscitation

Venous Congestion in Pediatric Critical Care

Don't Forget the Bubbles

FEBRUARY 17, 2025

Venous Congestion in Adult Critical Care In adults, venous congestion is a well-recognized contributor to organ dysfunction in many conditions, including septic shock and heart failure. In the adult population, for example, most cases of volume-overloaded congestion respond well to diuretics, as these are often related to left heart failure.

Pediatrics

Pediatrics Ultrasounds Shock Resuscitation

Emergency Care Today

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

Trauma Resuscitation Updates

Trending Sources

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

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

EM@3AM: Leukopenia

EM@3AM: Stercoral Colitis

Best Practices for Upper Gastrointestinal Hemorrhage

Sepsis Updates Relevant to the Emergency Physician

Neonatal Hypotension

emDOCs Revamp – Acute Chest Syndrome

Bubble Wrap PLUS – July 2024

The CLOVERS Trial

Paediatric IV Fluid Prescribing

Cholera: ED presentation, evaluation, and management

IV fluids in the ED: When do we really need them?

Venous Congestion in Pediatric Critical Care

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