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Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

RebelEM

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?

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Trauma Resuscitation Updates

RebelEM

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]

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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Hypervolemia – leads to pulmonary edema: Consider diuresis If euvolemic – start maintenance fluids of D5 in 0.45%NS Consider risk factors for multi-drug resistant microbes: Recent IV antibiotics Hospitalization within 90 days.

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emDOCs Podcast – Episode 101: Acute Chest Syndrome Part 2

EMDocs

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. If euvolemic – start maintenance fluids of D5 in 0.45%NS Consider risk factors for multi-drug resistant microbes: Recent IV antibiotics Hospitalization within 90 days. Blood transfusion Reduces the overall proportion of HbS.

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EM@3AM: Amniotic Fluid Embolism

EMDocs

Authors: Kyle Smiley, MD (EM Resident Physician, San Antonio, TX) and Brit Long, MD (@long_brit, EM Attending Physician) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital); Sophia Görgens, MD (EM Physician, Northwell, NY); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan (..)

EMS 96
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ToxCard: Iron

EMDocs

Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Blood transfusion for clinically significant blood loss. Case Follow-up: The patient received a fluid resuscitation with 20 mL/kg bolus of normal saline. Basic assessment: airway, breathing, circulation.

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. Triage vital signs include BP 127/81, HR 119, T 102.9 C or 100.4 mg/kg, max 0.4