RebelEM

SEPTEMBER 29, 2022

There are also potential harms to large volume fluid resuscitation including progression of pancreatitis and fluid overload with or without respiratory failure. Though the initial recommendation for aggressive fluid resuscitation was not based on substantial evidence, clinicians have been slow to pivot away from this approach.

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

Taming the SRU

MAY 11, 2024

r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Flood syndrome- start fluids, give antibiotics, consult surgery. Ways to get involved?

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

ACEP Now

OCTOBER 3, 2023

This guideline revision is particularly timely as EMS systems have shown their abilities to dramatically improve survival and neurologic outcome after cardiac arrest, STEMI, acute stroke, and other time-sensitive conditions. Hypotensive patients should be treated with blood products and/or isotonic fluids in the prehospital setting.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation Pediatrics 98

EMDocs

NOVEMBER 1, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

Operations 86

Operations Radiology Radiology Fluid Resuscitation 86

EMDocs

AUGUST 17, 2023

The median amount of fluids administered between the groups before initiation of NE was not statistically significant (2080 mL vs. 1900 mL). The study was performed when Surviving Sepsis Campaign Guidelines were used, so it was more common to see large volume fluid administration in the setting of sepsis. vs 48.4% (OR 3.4,

Sepsis 86

Sepsis Shock Resuscitation Fluid Resuscitation 86

RebelEM

OCTOBER 2, 2023

Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. appeared first on REBEL EM - Emergency Medicine Blog. However, it is unclear if all degrees (mild, moderate, severe) of DKA require the same intensive treatment. Acad Emerg Med 2023.

Operations 97

Operations Academics Fluid Resuscitation Outcomes 97

The Skeptics' Guide to EM

JUNE 12, 2022

Case: A 62-year-old man is brought in by EMS from home with lethargy and hypotension. saline, that may be partly driven by kidney injury associated with the administration of high-chloride content IV fluids. Since then that debate has broadly centered on the choice between what we will call “abnormal saline” (0.9%

Fluid Resuscitation 53

Fluid Resuscitation Resuscitation Outcomes Administration 53

The Skeptics' Guide to EM

FEBRUARY 17, 2018

Case: EMS is dispatched to a retirement […] The post SGEM#207: Ahh (Don’t) Push It – Pre-Hospital IV Antibiotics for Sepsis. Case: EMS is dispatched to a retirement home. Other serious time-dependent conditions such as myocardial infarction and trauma have been improved significantly with emergency medical services (EMS).

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

PHEM Cast

APRIL 10, 2016

And from our buddies at HEFT EM CAST: [link] A bit more detail covering some of the research in an easy to understand way. An amazing podcast on the subject can be found at SMART EM: SMART Testing: Back to Basics As always, any feedback, comments etc. Báez AA, Hanudel P, Perez MT, Giráldez EM, Wilcox SR. March 2016. South Med J.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

EB Medicine

OCTOBER 1, 2018

And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. Jeff : I’m an EMS fellow, what can I say… Anyway, on to my favorite section -- prehospital care. Let’s start with fluids.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

Dr. Smith's ECG Blog

MAY 5, 2022

Submitted and written by Destiny Folk MD , peer reviewed by Meyers, Smith, Grauer, McLaren A man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. EMS arrived and found him awake and alert. Fluid resuscitation was initiated.

EKG/ECG 52

EKG/ECG Fluid Resuscitation EMS Shock 52

Taming the SRU

MARCH 31, 2023

of emergency medicine residents report 1 or more dimensions of burnout (Lin Annals Emerg Med 2019) Moral Injury with COVID “We pushed aside our fear and frustration to focus on saving the patients in front of us; we kept our eyes open, and our feelings closed.

Allergic Reactions 40

Allergic Reactions Seizures Anaphylaxis Leadership 40

EMDocs

DECEMBER 18, 2023

Today, she would not get out of bed, prompting the facility to call EMS. 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.

Sepsis 83

Sepsis Fluid Resuscitation Resuscitation Shock 83

EMDocs

JULY 17, 2023

3,14 There are currently no good studies of enteric or rectal contrast administration in the evaluation of LBO and there are no society recommendations for its use. This also serves as a tool for surgical planning. 2,3,5 A CT scan with IV contrast is reported as 96% sensitive and 93% specific for LBO.

Operations 95

Operations EMS Fluid Resuscitation Shock 95

EMDocs

JULY 19, 2023

8 As always, remember to correct electrolyte abnormalities and provide fluid resuscitation as indicated. Food and Drug Administration. Food and Drug Administration. This condition is difficult to reverse; supportive measures should be undertaken, with chelation considered. Resources: S. 2022, February 25).

Poisoning 84

Poisoning Fluid Resuscitation Administration Seizures 84

RebelEM

DECEMBER 23, 2024

VOE is often complicated by hypovolemia, making fluid administration a common intervention ( Lovett 2017 ). saline (NS) solutions are both isotonic crystalloids widely used for intravenous fluid resuscitation across many contexts and disease states ( Myburgh 2013 ). Lactated Ringer (LR) and 0.9% JAMA Intern Med.

Fluid Resuscitation 124

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 124

EMDocs

JANUARY 20, 2025

Since the 2010s multiple trials have explored the feasibility of fluid restrictive resuscitation both on initial resuscitation in the ED, as well as in the intensive care unit (ICU). It may be reasonable to consider IV fluid administration in patients with moderate dehydration or prolonged vomiting. Keijzers, G.,

Dehydration 73

Dehydration Fluid Resuscitation Sepsis Resuscitation 73

EMDocs

MARCH 11, 2024

Authors: Gaston Omba, MD (EM Resident Physician, Makerere University); Jessica Pelletier, DO (EM Education Fellow, Washington University in St. 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.

Dehydration 107

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 107