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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

RebelEM

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. Click here for Direct Download of the Podcast Paper: Bouzat P et al. Severe acute traumatic coagulopathy = PT >1.5

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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. Administer O2 if necessary.

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REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

RebelEM

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. The secondary outcome of mortality was not statistically different however numerically favored the early use of norepinephrine. This resulted in better shock control by 6hrs (76.1%

Sepsis 99
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REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

RebelEM

Click here for Direct Download of the Podcast Paper: Knack SKS et al. It is possible that the induction agent used could play an important role on hemodynamic effects in critically ill adults. REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

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REBEL Cast Ep122 – Delayed vs Rapid Sequence Intubation in Agitated Trauma Patients

RebelEM

This helps relieve agitation/pain while maintaining spontaneous breathing and airway reflexes allowing for adequate pre-oxygenation as well as facilitates other resuscitation interventions including IV access, vasopressors, fluids, etc. that would not be possible in an agitated/combative patient.

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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. mg/dL] as compared to BaSICS [i.e.,

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Episode 7: Sepsis

PHEM Cast

It is worth noting, that with “Sepsis 3” many of these terms will become out-of-date – but validation work is required… The Rivers’ paper can be accessed here: [link] It was a single centre study which compared standard care with protocolised resuscitation packaged together as early goal-directed therapy (EGDT).

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