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Trauma Resuscitation Updates

RebelEM

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. NEJM 1994. [2] NEJM 1994. [2]

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

RebelEM

saline (NS) solutions are both isotonic crystalloids widely used for intravenous fluid resuscitation across many contexts and disease states ( Myburgh 2013 ). PMID: 39250114 Clinical Question: In adult patients admitted for a vaso-occlusive episode, does early fluid resuscitation with Lactated Ringer solution compared to 0.9%

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How Quickly to DSED | Whole Blood Transfusions

JournalFeed

Tuesday Spoon Feed: Trauma patients who were resuscitated with whole blood compared to component therapy had improved 24-hour mortality and a decrease in the total amount of blood products needed for resuscitation. These are summaries from just 2 of the 5 article we cover every week!

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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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Rethinking the Role of TXA: Are We Asking Too Much?

RebelEM

Primary Results Patients enrolled from 15 emergency medical services at 21 hospitals across 3 countries over 7 years. The study is relatively small (CRASH2 enrolled > 20,000 patients); just 1300 patients from 21 hospitals over 7 years. Resides in a facility for older persons. 1310 patients were recruited and randomized.

Outcomes 105
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emDOCs Podcast – Episode 100: Acute Chest Syndrome Part 1

EMDocs

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Consider risk factors for multi-drug resistant microbes: Recent IV antibiotics Hospitalization within 90 days. COVID-19 and ACS COVID increases the risk of hospitalization, pneumonia, pain, and ACS in SCD patients. times maintenance.

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emDOCs Podcast – Episode 102: Hypocalcemia in Trauma and the Diamond of Death

EMDocs

Calcium and resuscitation Severely injured trauma patients are commonly hypocalcemic. Up to 56% have an ionized Ca < 1 mmol/L, and this increases mortality and need for transfusion. Transfusion induced hypoCa is common in patients undergoing massive transfusion. Transfusion-Related Hypocalcemia After Trauma.