2023 Fluid Resuscitation Wellness 
Mind The Bleep
OCTOBER 29, 2024
Alkali burns result in liquefaction necrosis, allowing for deeper tissue injury as well as vascular injury that can lead to both local and systemic toxicity [1]. Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% Updated 2023 Jul 17]. Updated 2023 Jul 17]. Chemical Burns. PMID: 7077702.
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. NEJM 1994. [2] NEJM 1994. [2] Intensive Care Med 2020. [13]
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Don't Forget the Bubbles
OCTOBER 7, 2024
The high voltage can cause direct thermal injuries, as well as mechanical injuries from falls or secondary trauma. Judicious fluid resuscitation is critical; patients may become volume-deplete due to fluid loss/oedema secondary to burns. Philadelphia, PA: Elsevier; 2023:chap 130. Resuscitation. Culnan, D.M.,
EMDocs
JUNE 22, 2024
The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. Amniotic fluid embolism: a reappraisal. 2023 Dec 13;52(2):126-135. doi: 10.1515/jpm-2023-0365. “Amniotic fluid embolism.” A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance.
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. What are vasoactive drugs?
EMDocs
NOVEMBER 1, 2023
ECG – May show tachycardia or rate related ST depressions Laboratory evaluation: CBC w/ differential – may reveal leukocytosis with left shift CMP, Lipase – can reveal alternative intra-abdominal diagnoses as well as show findings of end-organ hypoperfusion (elevated serum creatinine, transaminitis, etc.) Accessed September 30, 2023.
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.
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