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. I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. vs SBP target <90mmHg which resulted in a mortality of 33.4%

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

PHEM Cast

FEBRUARY 23, 2017

Priorities for the bleeding trauma patient must include: Minimum time to control of bleeding (tourniquets / haemostatics / knife / interventional radiology) Normothermia Appropriate choice of destination (knife / IR) ? Prehospital Blood Product Resuscitation for Trauma. Lots to think about! 2016 Jul;46(1):3–16.

Blood Transfusions 52

Blood Transfusions Head Injuries Resuscitation Radiology 52

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

RCEM Learning

NOVEMBER 28, 2022

REBOA Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is increasingly used as a non-invasive clamp of the aorta. Case courtesy of Dr Paul Clarke Learning bite Avoid unnecessary movement of the patient. DO NOT “spring” the pelvis on examination and DO NOT log-roll if pelvic injury suspected. From the case rID 52597 Fig.

Fractures 52

Fractures Blood Transfusions Sepsis Operations 52

Taming the SRU

MAY 30, 2023

Legal implications vary from country to country. mg/mL) single-dose 2*-mL ampule or equivalent, 2 Lidocaine injection, 20-mg/mL single-dose 5-mL ampule or equivalent, 2 Nitroglycerin, 0.4-mg

OB/GYN 52

OB/GYN Ultrasounds Pediatrics Resuscitation 52

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. Severe bleeding and hemodynamically unstable patients: Not the time for colonoscopy; resuscitate and get the CTA. 2017;2(5):354–60.

Blood Transfusions 85

Blood Transfusions Outcomes Resuscitation Radiology 85

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