The Skeptics' Guide to EM

JUNE 12, 2022

Date: June 12th, 2022 Reference: Finfer et al. Date: June 12th, 2022 Reference: Finfer et al. Two large, cluster-randomized trials ( SMART and SALT-ED ) showed a small benefit to the use of balanced crystalloids in preventing a composite outcome of Major Adverse Kidney Events within 30 days (aka MAKE-30).

Fluid Resuscitation 52

Fluid Resuscitation Resuscitation Outcomes Administration 52

ACEP Now

OCTOBER 3, 2023

These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations. Accessed 2022, [link]. Prehosp Emerg Care. Bell JM, Breiding MJ, DePadilla L. J Safety Res.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

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 2022 Aug;58:235-244. Epub 2022 Jun 11. times maintenance. Am J Emerg Med. PMID: 35717760.

Blood Transfusions 78

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 78

Dr. Smith's ECG Blog

AUGUST 2, 2024

the investigators reviewed outcomes in 118 patients presenting with NSTEMI. 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 ). 118.007305) from Heitner et al. ,

EKG/ECG 105

EKG/ECG Fluid Resuscitation Academics Resuscitation 105

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 2022 Aug;58:235-244. Epub 2022 Jun 11. Causes and outcomes of the acute chest syndrome in sickle cell disease. times maintenance. Am J Emerg Med.

Blood Transfusions 76

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 76

EMDocs

JUNE 27, 2024

2022 Jul 5;328(1):57-68. 2022 Aug;58:235244. Epub 2022 Jun 11. 2022 Aug;58:235-244. Epub 2022 Jun 11. 2022 Aug 29;13:796837. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. C or 100.4 Front Physiol.

Pediatrics 76

Pediatrics Dehydration EMS Hospitals 76

Mind The Bleep

OCTOBER 29, 2024

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications. Proper stabilization and detailed communication with the burns centre are essential for optimal patient outcomes. Epub 2022 Mar 4.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

EMDocs

JANUARY 11, 2025

If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. Stercoral Colitis in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes. Mathis, K. L., & Lindor, R. link] Chakravartty, S.,

EMS 72

EMS Sepsis Shock Fluid Resuscitation 72

EMDocs

NOVEMBER 20, 2023

Hemodynamic resuscitation Key Concept: Patients with hemodynamic instability and/or suspected ongoing bleeding should receive intravenous fluid resuscitation with the goal of optimization of blood pressure and heart rate before endoscopic evaluation/intervention. Epub 2022 Sep 21. Am J Gastroenterol. doi: 10.14309/ajg.0000000000002130.

Resuscitation 80

Resuscitation Fluid Resuscitation Hospitals Research 80

ACEP Now

OCTOBER 9, 2024

In the emergency department (ED), physicians face the challenge of making rapid decisions that can significantly impact patient outcomes. However, the persistence of tachycardia despite fluid resuscitation and dosing with lorazepam to help with his panic disorder raised concerns that warranted further investigation.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Ultrasounds Outcomes 52

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 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

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. In 2022, the CLASSIC trial was published which provided one investigational angle to this important question.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

ACEP Now

OCTOBER 11, 2024

1,2 Clinical outcomes in submersion injuries are largely dependent on the degree of hypoxic injury experienced by the victim, making prehospital care of paramount importance. Fluid resuscitation will likely be warranted, and with crystalloid solution is most appropriate. pediatric hospitals. Acad Pediatr. 2024;24(4):677-685.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

Northwestern EM Blog

FEBRUARY 14, 2022

The primary outcome of the study was the response in MAP three hours after the start of angiotensin II infusion. It showed improvement in blood pressure which is a clinically important parameter but not a patient-oriented outcome. 2022, Feb 14). Expert Commentary Thank you for this great summary of the ATHOS 3 trial.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

EMDocs

DECEMBER 18, 2023

Multiple studies published in 2022 have indicated that, despite disagreement surrounding prognostic accuracy, no such screening tool so far exists. 13,14 Fluids Fluid resuscitation is a mainstay of sepsis therapy, as the condition is commonly associated with both absolute and relative hypovolemia.

Sepsis 65

Sepsis Fluid Resuscitation Resuscitation Shock 65

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 96

Fluid Resuscitation Hospitals Dehydration Research 96

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. 2022 May 17;145(20):e1053].

EMS 74

EMS Fluid Resuscitation Shock EKG/ECG 74

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. Updated 2022 Oct 24]. Temps greater than 41.5C BMC research notes , 8 , 758.

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68

EMDocs

JANUARY 20, 2025

One of the hallmarks of sepsis care, based on the Rivers 2001 17 trial and still recommended by the latest SCCM guidelines is early detection of sepsis and initiation of early resuscitation. link] During the 2017 IV fluid shortage, Patino et al. Inwald et al. Choudhari et al.

Dehydration 40

Dehydration Fluid Resuscitation Sepsis Resuscitation 40