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 98

Poisoning Fluid Resuscitation Seizures Resuscitation 98

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 93

Sepsis Fluid Resuscitation Resuscitation Shock 93

EMDocs

JUNE 25, 2024

Consider escharotomy if there is any issue with perfusion or neurologic deficit, as well as difficult ventilation in the intubated patient. Fluid resuscitation target and fluid Fluid resuscitation is one of the most important parts of management; goal is to increase intravascular volume and ensure end organ perfusion.

Burns 97

Burns Fluid Resuscitation Resuscitation Poisoning 97

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]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Don't Forget the Bubbles

MARCH 31, 2025

Lack of fluid monitoring throughout the PICU stay led to underreporting of MODS resulting from late-onset FO. Sepsis is a significant cause of mortality in children, and fluid resuscitation is a key treatment strategy. Prolonged fluid overload may still contribute to organ dysfunction over time. Why does it matter?

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

ACEP Now

OCTOBER 3, 2023

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.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation Pediatrics 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 92

Resuscitation Administration Fluid Resuscitation Research 92

Northwestern EM Blog

MAY 9, 2022

There is no gold standard with respect to its definition, and it requires a medication history (which we typically don't do very well in the emergency department). Therefore, fluid resuscitation and maintenance are important. NMS is hard to diagnose because it's rare. A tricky cause of NMS is the removal of a dopamine agonist.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Emergency Department 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. 2018, Kuttab, Lykins et al. 2019, Evans, Rhodes et al. 2021, Im, Kang et al. vs 33.2%; OR, 0.42; 95% CI 0.32-0.55;

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Don't Forget the Bubbles

JUNE 10, 2024

Baby A, a preterm infant, appears to be faring well for the moment—requiring minimal respiratory support, on full feeds, without IV access, and generally in an okay condition. Welcome to your first day with the neonates! Upon arriving for your initial shift, you set down your bag, and shortly after, you’re asked to evaluate Baby A.

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. older than 65 years; b.]

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

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

EB Medicine

OCTOBER 1, 2018

Jeff : So as well all know Sepsis is bread and butter emergency medicine, but, what is sepsis? 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. Let’s start with fluids.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

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 129

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 129

Don't Forget the Bubbles

NOVEMBER 18, 2024

However, if the infant is well-perfused, cardiovascularly stable, and showing no signs of organ dysfunction, active treatment may not be necessary. Before considering fluid resuscitation or inotropes, it is essential to correct the infant’s body temperature. This can manifest as hypotension.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

EMDocs

JANUARY 20, 2025

1,2 For hypervolemia in heart failure patients, orthopnea >2 pillows is the most reliable clinical finding, 3,4 though an increase in peripheral edema and increased weight can be useful as well. 6-8 In patients who are on long-term hemodialysis, typical non-invasive signs of volume assessment seem to be unreliable as well.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

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. Clinicians should switch from IV hydration to ORS once hydration is improved and the patient can drink.

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111

Taming the SRU

AUGUST 25, 2023

bicarb <18mEq/L) ketosis (preferably serum beta-hydroxybutyrate >3mmol/L) Risk factors SGLT2 inhibitor use fasting state ketogenic diet intra-abdominal pathology (AGE, pancreatitis, etc.)

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75