Remove Burns Remove Outcomes Remove Shock
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Chemical Burns

Mind The Bleep

Chemical burns are a unique subset of burns that require specialised management due to the nature of the substances involved. The majority of acid burns cause coagulative necrosis and cytotoxicity leading to skin and mucosal changes that limit deeper injury. Check temperature and blood glucose levels.

Burns 52
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Adjunctive Methylene Blue in Septic Shock?

RebelEM

septic shock). Limited, small studies on its use in septic shock do not make a clear argument for use. Early Adjunctive Methylene Blue in Patients with Septic Shock: A Randomized Controlled Trial. Background: Sepsis can induce numerous physiologic derangements. Paper: Ibarra-Estrada, M et al. Crit Care 2023. 95% CI 15.4

Shock 145
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Electrical injuries

Don't Forget the Bubbles

Up to 5% of burns occur secondary to electrical injuries, and this rises to 27% in developing countries. Significant injuries can occur even in the absence of extensive burns or other signs of external injury. Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)?

Burns 80
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52 in 52 – #41: The CENSER Trial

EMDocs

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 86
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Another Study on Peripheral Vasopressors

RebelEM

Background: Use of vasopressors is a common practice to support hemodynamics and optimization of tissue perfusion in patients presenting with shock. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. of patients not requiring CVC insertion. CHEST 2024. PMID: 37611862 Evans L et al.

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Grand Rounds Recap 9.6.23

Taming the SRU

ETT onto a fiberoptic scope.

CPR 90
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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ).