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Patients present to the ED with hypovolemia secondary to a plethora of causessome requiring IV fluidresuscitation and others requiring none. Considering the nationwide IV fluid shortage, judicious use of fluids is imperative. IV fluidadministration was more associated with phlebitis.
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. Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. Antiemetics as needed.
This should include early identification of life-threatening injuries, targeted fluidresuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluidresuscitation. You feel the patient needs fluidresuscitation.
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 fluidadministration in the setting of sepsis. vs 48.4% (OR 3.4,
1 , 2 The most common non-iatrogenic cause is spontaneously due to increased intraesophageal pressure, Boerhaave syndrome, from forceful retching, coughing, straining, seizures, or even childbirth (15% of cases). 4 Fluidresuscitation and vasopressor use as appropriate. PPI administration to decrease gastric acid secretion.
Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. Hypotensive patients should be treated with blood products and/or isotonic fluids in the prehospital setting. References Lulla A, et al.
Patient C, a 27-year-old female with a history of epilepsy, taking valproate and endorsing adherence, is then brought in by ambulance for a witnessed seizure. This is her first seizure in six years. Management of symptoms is the same for all of these, relying upon fluidresuscitation, antiemetics, and electrolyte repletion.
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.
Further, organic mercury readily crosses the placenta where it acts as a teratogen leading to a wide range of birth defects including developmental delay, blindness, seizures, and limb malformation. 8 As always, remember to correct electrolyte abnormalities and provide fluidresuscitation as indicated. Resources: S.
to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2 to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2 to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1
Patients who cannot tolerate oral intake of fluids should receive intravenous (IV) fluidresuscitation but are encouraged to start drinking ORS as soon as they are able. Among children, hypoglycemia is common and can lead to seizures.
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