Remove 2023 Remove Fluid Resuscitation Remove Shock
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Adjunctive Methylene Blue in Septic Shock?

RebelEM

septic shock). Judicious fluid resuscitation is indicated in patients with signs of hypo perfusion but is often inadequate necessitating the administration of vasoactive medications. Limited, small studies on its use in septic shock do not make a clear argument for use. Crit Care 2023. 95% CI 15.4 95% CI 15.4

Shock 145
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A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Don't Forget the Bubbles

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
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Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

RebelEM

This systematic review and meta-analysis attempts to elucidate whether a more conservative fluid resuscitation approach is warranted in volume sensitive sepsis patients, such as those with congestive heart failure (CHF). Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Am J Emerg Med. 2023;73:34-39.

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Trauma Resuscitation Updates

RebelEM

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]

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Electrical injuries

Don't Forget the Bubbles

Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)? Children, especially toddlers, may insert objects into outlets, leading to shocks or burns. Electrical devices used near water sources can cause severe shocks. Was the voltage high or low (as below)?

Burns 80
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EM@3AM: Retroperitoneal Hematoma

EMDocs

Clinical features include abdominal or flank pain; ecchymosis to the flank, periumbilical region, proximal thighs, or scrotum; and hemorrhagic shock early in the disease course. 5 Clinical Presentation: 1-3 Variable presentation but may present with dropping hemoglobin/hematocrit without other findings in spontaneous cases.

EMS 74
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Chemical Burns

Mind The Bleep

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications. Updated 2023 Jul 17]. Updated 2023 Jul 17].

Burns 52