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Grand Rounds Recap 6.19.2024

Taming the SRU

Other medical interventions include PPIs, octreotide, erythromycin, and blood transfusion as needed. TEE can be helpful in guiding resuscitation if available. Blood transfusion may be useful in patients with penetrating trauma, although we must acknowledge when efforts are futile.

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EM@3AM: Amniotic Fluid Embolism

EMDocs

Answer : Amniotic fluid embolism Epidemiology: Incidence of 1:15,200 to 1:53,400 1 7% occur during labor Causes approximately 14% of all maternal peripartum death in United States Current fatality rate 13-60% 1-4 Risk factors: Advanced maternal age, amniocentesis, cesarean delivery, eclampsia, medical induction of labor, placental pathology, diabetes, (..)

EMS 110
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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

ECG: Evaluate for ischemia, right heart strain. Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Overestimates arterial oxygen saturation. Up to 3x less accurate in black patients. When the clinical picture does not match the SpO 2 , get an ABG. Use a co-oximeter to measure different types of Hb.

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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

ECG: Evaluate for ischemia, right heart strain. Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Blood transfusion Reduces the overall proportion of HbS. Overestimates arterial oxygen saturation. Up to 3x less accurate in black patients. Decreases splinting and improves tidal volumes.

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Massive Transfusion for Motorcycle Collision with Hemorrhage, Troponin Elevated.

Dr. Smith's ECG Blog

This ECG was done in a middle aged woman who was in a motor vehicle collision in which her vehicle "T-boned" another, so there was trauma to the anterior chest. She had multiple rib fractures as well as serious hemorrhage and underwent massive transfusion. ng/mL, and an ECG was recorded: There are no P-waves visible.

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Episode 26 – Blunt Cardiac Injury: Emergency Department Diagnosis and Management (Trauma CME)

EB Medicine

Again, no standard definition exists, with some diagnostic criteria including simply chest pain and increasing cardiac enzymes, and others including cardiac dysfunction, ecg abnormalities, wall motion abnormalities, and an elevation of cardiac enzymes. New EKG findings requires admission for monitoring. of those patients.

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Vasopressor Nonresponse

Northwestern EM Blog

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. There is a subset of patients who, despite aggressive conventional resuscitation, have an inadequate hemodynamic response and develop refractory shock. due to inadequate access.