Mind The Bleep

DECEMBER 19, 2023

It is also vital to do a fluid balance assessment. Majority of DKA patients are in a fluid deficit and present acutely with shock. Therefore, they require fluid resuscitation to restore blood pressure, correct the ketonemia and electrolyte abnormalities, and oliguria. This is done with an initial bolus of 10ml/kg 0.9%

Dehydration 98

Dehydration Fluid Resuscitation Shock Resuscitation 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 92

Operations Radiology Radiology Fluid Resuscitation 92

PHEM Cast

APRIL 10, 2016

The control group received many similar treatments as the ‘intervention’ group (just not full protocolised EGDT) highlighting that with good sepsis care (fluid resuscitation, close monitoring, early appropriate antibiotic administration), mortality can be reduced. Severe Sepsis in Pre-Hospital Emergency Care.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Taming the SRU

APRIL 10, 2023

HOSPITAL COURSE The patient was initially found to be hypotensive in the Emergency Department with a blood pressure of 87/58 mmHg. He was given an intravenous fluid bolus with minimal improvement in his blood pressure, but remained alert. Her oxygen requirement decreased throughout her hospitalization. Diagnostics WBC : 8.6

EKG/ECG 52

EKG/ECG Fluid Resuscitation Administration Emergency Department 52

RebelEM

NOVEMBER 30, 2023

For those with sepsis, the administration of intravenous fluids (IVF) at the volumes recommended in the Surviving Sepsis Campaign (SSC) requires careful consideration of an individual’s chronic medical conditions and subsequent sensitivity to IVF. Studies without a clear timeframe for fluid administration.

Sepsis 121

Sepsis Fluid Resuscitation Resuscitation Administration 121

EMDocs

DECEMBER 6, 2024

In 1997, the Food and Drug Administration (FDA) mandated unit-dose packaging for all iron-containing products with more than 30 milligrams of elemental iron. Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Basic assessment: airway, breathing, circulation. Antiemetics as needed.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

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.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

RebelEM

MAY 25, 2023

Lancet 2010 [10] >20,000 adult trauma patients with SBP <90mmHg Patients randomized to TXA 1g over 10 min + 1g IV over 8hrs vs Placebo given within 8hrs of injury In-hospital mortality by 28d reduced (14.5% NEJM 1994. [2] NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

RebelEM

MAY 29, 2023

Judicious fluid resuscitation is indicated in patients with signs of hypo perfusion but is often inadequate necessitating the administration of vasoactive medications. It also reduced length of stay in ICU and hospital without adverse effects. septic shock). NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9%

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

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.

Sepsis 90

Sepsis Fluid Resuscitation Resuscitation Shock 90

Don't Forget the Bubbles

MARCH 31, 2025

It evaluates the impact of FO (defined as >10% fluid accumulation within 24 hours of ICU admission) on mortality, mechanical ventilation (MV) requirements, multiple organ dysfunction syndrome (MODS), and length of hospital stay. Sepsis is a significant cause of mortality in children, and fluid resuscitation is a key treatment strategy.

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

ACEP Now

OCTOBER 3, 2023

There are at least 600 TBI-related hospitalizations and 175 TBI-related deaths per day. 2,3 TBI outcomes are profoundly linked to the timing and quality of care provided before patients reach the hospital. Hypotensive patients should be treated with blood products and/or isotonic fluids in the prehospital setting.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

Taming the SRU

MAY 11, 2024

Flood syndrome- start fluids, give antibiotics, consult surgery. Be careful with fluid resuscitation in renal transplant patients who can be at risk for volume overload. 3% HTS appears to be safe for peripheral IV administration and does not require a central line. Immunosuppression can blunt the typical immune response.

Resuscitation 93

Resuscitation Administration Fluid Resuscitation Research 93

Northwestern EM Blog

MAY 9, 2022

For this reason, carbidopa/levodopa should never be discontinued during hospital admission - or ED boarding. [1] Therefore, fluid resuscitation and maintenance are important. Delayed Administration and Contraindicated Drugs Place Hospitalized Parkinson’s Disease Patients at Risk. References 1. 12 March 2015.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Emergency Department 52

ACEP Now

OCTOBER 11, 2024

Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. 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. pediatric hospitals. South Med J.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

Taming the SRU

MAY 5, 2023

Despite the complexity and heterogeneity of patients with sepsis, there have been few interventions which have been demonstrated to decrease mortality: early antimicrobial and fluid administration (Levy, Evans et al. vs 42.1%), as were days alive outside of the hospital and days without life support (Meyhoff, Hjortrup et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

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. 13 Depending on the hospital staffing, this may be a gastroenterology consult or a surgical consult. This also serves as a tool for surgical planning.

Operations 97

Operations EMS Fluid Resuscitation Resuscitation 97

Mind The Bleep

MAY 12, 2023

Administration of human albumin solution (HAS) in SBP reduces the incidence of renal failure by 72% and mortality by 47%. In those who are grossly obese, it may be better to employ a more cautious approach with regard to albumin administration. The number needed to treat to prevent one death is around 5 in SBP. On Day 3 (i.e.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

EB Medicine

OCTOBER 1, 2018

For those listening, my hospital probably looks a little bit like yours. Roughly half of in-hospital mortality is associated with septic in some fashion. clearly this is an important topic if it warrants it’s own chair at a major hospital in NYC. At our hospital in southern Manhattan, patients tend to breathe around 16.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

Don't Forget the Bubbles

JUNE 10, 2024

Initial Management Supportive Care : Initial management involves stabilising the infant, which includes fluid resuscitation, cessation of enteral feeds, and provision of total parenteral nutrition (TPN) to rest the bowel and meet the nutritional needs of the infant. How do you treat necrotising enterocolitis?

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

PulmCCM

SEPTEMBER 9, 2021

Septic sheep randomized to early, rapid volume resuscitation had greater vasopressor requirements 12 hours after initial fluid bolus. It is suggested that rapid, fluid resuscitation generates an abrupt rise in atrial natriuretic peptide, shears the glycocalyx which then impairs vascular reactivity.

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

Dr. Smith's ECG Blog

MAY 5, 2022

Fluid resuscitation was initiated. A few days later an ECG was repeated which showed normal sinus rhythm with no further hyperkalemia findings: After a 3-week hospitalization for acute renal failure, hyperkalemia, and compartment syndrome, the patient was discharged to acute rehab. Here is the initial ED ECG: What do you think?

EKG/ECG 52

EKG/ECG Fluid Resuscitation EMS Shock 52

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 ). saline affect hospital-free days by day 30?

Fluid Resuscitation 128

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 128

Don't Forget the Bubbles

NOVEMBER 18, 2024

Epidemiology in Australia In Australia, the reported prevalence of neonatal hypotension in preterm infants is like that in the UK, with around 20-30% of very low birth weight infants experiencing significant hypotension during their initial hospital stay. Low doses can be given peripherally; however, central administration is preferred.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

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). 2024, 33 use of ultrasound may lead to a reduction in mortality, less volume of fluids given, and decreased hospital stay.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

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. However, in extreme cases with highly toxic levels, one could consider plasma exchange if no other suitable alternative exists. Resources: S.

Poisoning 91

Poisoning Fluid Resuscitation Administration Seizures 91

EMDocs

MARCH 11, 2024

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. Risk Factors for Severe Cholera among Children under Five in Rural and Urban Bangladesh, 2000–2008: A Hospital-Based Surveillance Study. 2023;8(3):169.

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111