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.

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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.

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Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

Mind The Bleep

OCTOBER 29, 2024

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].

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Burns Fluid Resuscitation PPE Resuscitation 52

Don't Forget the Bubbles

OCTOBER 7, 2024

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)?

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EMDocs

SEPTEMBER 7, 2024

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.

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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.

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Operations Radiology Radiology Fluid Resuscitation 93

ACEP Now

MARCH 14, 2024

Electrical injuries—excluding lightning injuries—account for roughly 10,000 nonfatal shock incidents a year and 500 deaths a year. 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. Accessed October 21, 2023.

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Taming the SRU

MAY 5, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. 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. N Engl J Med. 2023;388(6):499-510. 2021, Jarczak, Kluge et al.

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EMDocs

DECEMBER 18, 2023

Septic shock is high on the differential diagnosis for this patient’s presentation. Introduction Sepsis and septic shock are life-threatening conditions characterized by severe systemic inflammation and organ dysfunction due to a dysregulated host response to infection. What are the most up-to-date guidelines for managing this patient?

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EMDocs

JANUARY 20, 2024

Symptoms of heart failure and cardiogenic shock may develop in more severe cases. Answer: Takotsubo Cardiomyopathy 1-18 Background: Also known as transient apical ballooning syndrome, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, stress cardiomyopathy, Gebrochenes-Herz syndrome, and broken-heart syndrome.

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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. Pressors where indicated for septic shock (typically Norepinephrine starting at 0.05 Updated 2023 Nov 12].

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EMS Infectious Diseases Sepsis Hospitals 97

EMDocs

DECEMBER 16, 2023

Heat stroke can lead to end-organ dysfunction such as rhabdomyolysis, disseminated intravascular coagulation, cardiogenic shock, liver failure, and cerebral edema. Broad-spectrum antibiotics (A) for septic shock are not inappropriate given the hyperthermia, tachycardia, and hypotension. Temps greater than 41.5C Autonomic Dysfunction.

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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. Vasopressors such as noradrenaline are often required (systemic vasodilation is common in hepatic failure). link] Nickson, C.

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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.

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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.

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Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

FEBRUARY 17, 2025

Watching these signs, you pause he’s had 60ml/kg as fluid boluses, but what do you do with these signs? Volume resuscitation has historically been the first-line therapy for patients in septic shock. Is more fluid the answer? congenital heart disease, septic cardiomyopathy), aggressive volume resuscitation (e.g.

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Don't Forget the Bubbles

NOVEMBER 18, 2024

Before considering fluid resuscitation or inotropes, it is essential to correct the infant’s body temperature. Check electrolytes and consider the diagnosis, especially if the infant shows signs of shock or has a family history suggestive of CAH. This can lead to peripheral vasoconstriction and hypotension. and Roberts, N.

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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.

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EMDocs

MARCH 11, 2024

Inspection of the canister showed approximately ten liters of nearly odorless watery fluid containing flecks of mucus (“rice-water” stools) consistent with cholera infection. The clinical picture of this patient was consistent with hypovolemic shock secondary to acute cholera infection. Published online August 7, 2023.

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