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Major Trauma – Injuries by Assault

Don't Forget the Bubbles

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation.

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Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS

PulmCCM

Further, the treating clinician must have deemed either normal saline or balanced crystalloid as appropriate resuscitation options; the patient’s expected-admission to the ICU must have been at least 3 days. Death, from any cause, within 90 days of randomization was the primary outcome. Download his free textbook here.

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Episode 7: Sepsis

PHEM Cast

This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. Prehospital intravenous access and fluid resuscitation in severe sepsis: an observational cohort study. Academic Emergency Medicine. 2014 Oct 28;:1–9.

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Back to the BaSICS: does the infusion rate of a fluid bolus affect mortality?

PulmCCM

Septic sheep randomized to early, rapid volume resuscitation had greater vasopressor requirements 12 hours after initial fluid bolus. It is suggested that rapid, fluid resuscitation generates an abrupt rise in atrial natriuretic peptide, shears the glycocalyx which then impairs vascular reactivity. more than 2].