Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. Obviously, one also needs to address the cause of the shock, or any efforts in resuscitation will only bring a temporary improvement. He presented tachycardic and hypotensive with a capillary refill time of 5 seconds.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

EMDocs

MAY 28, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Blood transfusion Reduces the overall proportion of HbS. Causes and outcomes of the acute chest syndrome in sickle cell disease. Decreases splinting and improves tidal volumes. If euvolemic – start maintenance fluids of D5 in 0.45%NS

Blood Transfusions 75

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 75

EMDocs

DECEMBER 6, 2024

7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Blood transfusion for clinically significant blood loss. Antiemetics as needed.

Poisoning 76

Poisoning Fluid Resuscitation Seizures Resuscitation 76

EMDocs

JUNE 27, 2024

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. Pediatr Blood Cancer. Triage vital signs include BP 127/81, HR 119, T 102.9

Pediatrics 75

Pediatrics Dehydration EMS Hospitals 75

Downeast Emergency Medicine

APRIL 26, 2021

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. JAMA Neurol.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Northwestern EM Blog

JANUARY 24, 2022

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.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Don't Forget the Bubbles

NOVEMBER 18, 2024

Research and guidelines from Australian centres, like those published by the Australian and New Zealand Neonatal Network (ANZNN), emphasize early detection and management to improve outcomes. Effective management of MAS will often result in the stabilization of blood pressure. After any stressful situation, don’t forget to debrief.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

EMDocs

JUNE 3, 2023

5 Initial Evaluation The key to the initial resuscitation of the unstable pelvic trauma patient is to rapidly identify and treat the most life-threatening pathology. 13 Massive transfusion protocols (MTP) are hallmarks of trauma resuscitation, and they are critical to the unstable pelvic fracture patient.

Fractures 54

Fractures Resuscitation Operations EMS 54

EB Medicine

OCTOBER 1, 2018

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. Patient’s need adequate fluid resuscitation. Just a reminder that a history of CHF doesn’t preclude proper fluid resuscitation.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EB Medicine

MARCH 1, 2019

Jeff: In terms of initial resuscitation, there is an ever increasing body of literature to support blood transfusion over crystalloid in patients requiring volume expansion in trauma. There are no specific guidelines for transfusion in the setting of blunt cardiac injury, so stick to your standard trauma protocols.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EMDocs

MARCH 6, 2024

In other patients who are stable and the bleeding has resolved, CTA is of low yield If they are critically ill and have severe bleeding, resuscitate first and consult IR, radiology, and surgery. There is no clear improvement with idarizucimab or andexanet alfa on patient-oriented outcomes. If severe bleeding, administer PCC.

Blood Transfusions 86

Blood Transfusions Outcomes Resuscitation Radiology 86

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64