Don't Forget the Bubbles

MARCH 31, 2025

Association between fluid overload and mortality in children with sepsis: a systematic review and meta-analysis. 2023 Nov;7(1):e002094. doi: 10.1136/bmjpo-2023-002094. The article is a systematic review and meta-analysis examining the association between fluid overload (FO) and mortality in children with sepsis.

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

EMDocs

FEBRUARY 20, 2024

Fluids in Pancreatitis #1 : de-Madaria E, Buxbaum JL, Maisonneuve P, et al; ERICA Consortium. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. cc/kg/hour of LR Control: LR Bolus of 20 cc/kg (regardless of fluid status) followed by 3.0 2.18) Fluid Overload: 20.5% 2023 Mar 22;27(1):122.

Fluid Resuscitation 98

Fluid Resuscitation Resuscitation Outcomes Hospitals 98

Don't Forget the Bubbles

FEBRUARY 5, 2025

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation.

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

EMDocs

NOVEMBER 29, 2023

EBM Update: Fluids in Pancreatitis, Hypertriglyceridemic Pancreatitis #1: de-Madaria E, Buxbaum JL, Maisonneuve P, et al; ERICA Consortium. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. cc/kg/hour of LR Control: LR Bolus of 20 cc/kg (regardless of fluid status) followed by 3.0 2023 Mar 22;27(1):122.

Fluid Resuscitation 93

Fluid Resuscitation Resuscitation Outcomes Hospitals 93

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. Updated 2023 Jul 17]. Updated 2023 Jul 17]. Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

RebelEM

FEBRUARY 24, 2025

Mar 2023; PMID: 36983218 Feissel M, et al. The respiratory variation in inferior vena cava diameter as a guide to fluid therapy. Apr 2023; PMID: 37009935. lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. Obviously, one also needs to address the cause of the shock, or any efforts in resuscitation will only bring a temporary improvement. So, fluid has been tried but has not got close to fixing the problem.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

EMDocs

JUNE 22, 2024

Amniotic fluid embolism: a reappraisal. 2023 Dec 13;52(2):126-135. doi: 10.1515/jpm-2023-0365. “Amniotic fluid embolism.” J Matern Fetal Neonatal Med. 2015 May;28(7):793-8. doi: 10.3109/14767058.2014.932766. Epub 2014 Jun 30. PMID: 24974876. Young BK, Florine Magdelijns P, Chervenak JL, Chan M. J Perinat Med.

EMS 111

EMS Resuscitation Blood Transfusions Seizures 111

EMDocs

SEPTEMBER 7, 2024

Laborator evaluation: CBC, CMP, lipase, type and screen, coagulation panel Treatment: 1-3 Resuscitation with blood products as necessary for hemodynamic stability. However, this patient’s response to fluid resuscitation, though only minimal to modest, indicates his ongoing bleeding is temporized with typical volume-mediated resuscitation.

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EMS Fluid Resuscitation Resuscitation Radiology 97

Don't Forget the Bubbles

OCTOBER 7, 2024

Judicious fluid resuscitation is critical; patients may become volume-deplete due to fluid loss/oedema secondary to burns. Philadelphia, PA: Elsevier; 2023:chap 130. Volume resuscitation in patients with high-voltage electrical injuries. Resuscitation. In: Walls RM, ed. Culnan, D.M., Capek, K.D., Jimenez, C.

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ACEP Now

OCTOBER 3, 2023

In April 2023, the third edition of the Brain Trauma Foundation’s evidence-based guidelines for the prehospital management of traumatic brain injury (TBI) was published in Prehospital Emergency Care. Hypotensive patients should be treated with blood products and/or isotonic fluids in the prehospital setting. References Lulla A, et al.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

EMDocs

NOVEMBER 20, 2023

Initial patient assessment and hemodynamic resuscitation should be performed simultaneously. DOAC reversal Recommendation: For patients on DOACs, we suggest reversal for the small subset of patients who present with a life-threatening LGIB that does not respond to initial resuscitation and cessation of the anticoagulant alone.

Resuscitation 104

Resuscitation Fluid Resuscitation Hospitals Research 104

EMDocs

NOVEMBER 1, 2023

6 Treatment : Airway Definitive airway management should be performed in those with respiratory distress with attention to appropriate resuscitation started beforehand in the setting of potential distributive shock from mediastinitis. 4 Fluid resuscitation and vasopressor use as appropriate. Accessed September 30, 2023.

Operations 93

Operations Radiology Radiology Fluid Resuscitation 93

RebelEM

OCTOBER 2, 2023

Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. Acad Emerg Med 2023. Acad Emerg Med 2023. However, it is unclear if all degrees (mild, moderate, severe) of DKA require the same intensive treatment. Paper: Griffey RT et al.

Operations 104

Operations Academics Fluid Resuscitation Outcomes 104

Dr. Smith's ECG Blog

AUGUST 2, 2024

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 ).

EKG/ECG 119

EKG/ECG Fluid Resuscitation Academics Resuscitation 119

ACEP Now

OCTOBER 11, 2024

3 Once the patient arrives in your emergency department, a rapid review of the patient’s status and results of resuscitative efforts should be performed. Fluid resuscitation will likely be warranted, and with crystalloid solution is most appropriate. 2023 Jun 14;49(1):74. 4 Another study cited only 2.3 Ital J Pediatr.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 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]. 2019 [cited 2023 Nov 30]. 2023 Aug 23 [cited 2023 Nov 30];151. 2016 Oct 10 [cited 2023 Nov 30];281(2):123–48. 2012 Mar 19 [cited 2023 Nov 30];55(1):33–41. Rch.org.au.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

ACEP Now

MARCH 14, 2024

Treatment for burns should focus on fluid resuscitation as appropriate based on your institution’s burn protocol per Brooke, Parkland, Rule of 10s etc. 2023 Jul 17. Treasure Island (FL): StatPearls Publishing; 2023 Jan– PMID: 28846317. Accessed October 21, 2023. In: StatPearls [Internet]. McGraw Hill; 2016.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

ACEP Now

FEBRUARY 11, 2024

Management of symptoms is the same for all of these, relying upon fluid resuscitation, antiemetics, and electrolyte repletion. Published December 18, 2023. Published January 2023.Updated Updated May 16, 2023. Published January 2023. Diabetes Care. 2018;41:258–66. CNN website. Accessed January 11, 2024.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

Taming the SRU

MAY 5, 2023

There was also an advantage of using MAP as an endpoint, which is a significant advantage as this is a standard resuscitation and hemodynamic end point in routine clinical care of patients in shock. Effect of an Early Resuscitation Protocol on In-hospital Mortality Among Adults With Sepsis and Hypotension: A Randomized Clinical Trial."

Sepsis 52

Sepsis Shock Administration Resuscitation 52

EMDocs

DECEMBER 18, 2023

13,14 Fluids Fluid resuscitation is a mainstay of sepsis therapy, as the condition is commonly associated with both absolute and relative hypovolemia. 15 Two changes were elucidated in the 2021 SSC guidelines for fluid resuscitation. Additionally, the recommendation to use a 30 cc/kg bolus was downgraded.

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Sepsis Fluid Resuscitation Resuscitation Shock 91

EMDocs

OCTOBER 7, 2023

neurologic damage and thrombosis) 20,21 Resuscitation Lactated ringers > Normal saline due to reduced need for urinary alkalinization 22 Place foley and target urine output >300 mL/hr Electrolyte abnormalities Hyperkalemia: Obtain an ECG Stabilization: Calcium gluconate 2 g over 5-10 min. Accessed February 3, 2023.

EMS 97

EMS Fluid Resuscitation Fractures Resuscitation 97

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. Updated 2023 Jan 9]. J Med Life.

EMS 101

EMS Fluid Resuscitation Shock EKG/ECG 101

EMDocs

OCTOBER 5, 2024

Management 9-12 Patients such receive standard resuscitation care including: Antipyretics such as Tylenol (650-1000 mg PO), Ibuprofen (600 mg PO), or Toradol (15mg IV). IV fluid resuscitation as needed. Updated 2023 Nov 12]. Instead, non-susceptibility to Ceftriaxone is often used as a proxy. J Antimicrob Chemother.

EMS 97

EMS Infectious Diseases Sepsis Hospitals 97

EMDocs

DECEMBER 16, 2023

Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. Ice water immersion and iced peritoneal lavage are additional methods used to lower temperature but are more invasive or can prevent additional resuscitative efforts.

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

Intensive Blog

FEBRUARY 9, 2023

Available from URL: [link] [Accessed 10 February 2023] Death Cap – Amanita phalloides. link] [Accessed 10 February 2023] Yartsev, A. link] [Accessed 10February 2023] Austin Clinical Toxicology Service. Early indicators of prognosis in fulminant hepatic failure. Gastroenterology, 97 (2), 439-445. link] Nickson, C.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Fluid Resuscitation Resuscitation 52

EMDocs

JUNE 27, 2024

Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Epub 2023 Nov 27. Fluid overload due to intravenous fluid therapy for vaso-occlusive crisis in sickle cell disease: incidence and risk factors. 2023 Apr;98(4):620-627.

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97

EMDocs

JANUARY 20, 2025

2023 10 found that clinicians were 56% accurate in their assessments of patients admitted for heart failure when compared to the gold standard of blood volume measurement – a nuclear study utilizing radiolabeled red blood cells and albumin. 9 In terms of assessing volume status in general, Joseph et al. 11 A study by Stephan et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

FEBRUARY 17, 2025

He has had some additional episodes of hypotension post-intubation, which is treated with further volume resuscitation. Before considering a further fluid bolus, you do a point-of-care ultrasound (POCUS). Watching these signs, you pause he’s had 60ml/kg as fluid boluses, but what do you do with these signs? Prager, R.,

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78

Don't Forget the Bubbles

JULY 3, 2024

2023 Oct 16;29(3):171-173. 2024 Jun 26:fetalneonatal-2023-326691. Fluid resuscitation in children with severe infection and septic shock: a systematic review and meta-analysis. Kidney function evaluation in children and adolescents with obesity: a not-negligible need. Barlabà A, et al. Eur J Pediatr. 2024 Jun 13.

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. “Epidemiology of Hypotension in Neonates,” Journal of Perinatology , 2023. Effective management of MAS will often result in the stabilization of blood pressure. and Roberts, N. Batton, B.,

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

EMDocs

MARCH 11, 2024

Rehydration therapy for patients with cholera should include volume resuscitation and electrolyte repletion. Patients who cannot tolerate oral intake of fluids should receive intravenous (IV) fluid resuscitation but are encouraged to start drinking ORS as soon as they are able. Published online August 7, 2023.

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111