RebelEM

MAY 18, 2023

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. The goal of the trial was to see if early vasopressors improved shock control by 6 hours. This resulted in better shock control by 6hrs (76.1%

Sepsis 89

Sepsis Shock Resuscitation Outcomes 89

RebelEM

SEPTEMBER 27, 2023

REBEL Core Cast 109.0 – Na Channel Blocker Poisoning Click here for Direct Download of the Podcast Definition and Physiology Standard definition of a wide QRS is anything > 120 msec (3 small boxes on the ECG) In the context of poisoning, a “wide QRS” is anything greater than 100 milliseconds. Boehnert 1985 ).

Poisoning 91

Poisoning Seizures Administration EKG/ECG 91

PulmCCM

NOVEMBER 11, 2023

If changes in P ra cause changes in CO, shouldn’t we then know the etiology of shock with certainty? Download his free textbook here and check out the remainder of this series. Can these data deduce CO? And this leads to therapy – if we desire to change CO, can we do so by altering P ra ? References 1.

Ultrasounds 87

Ultrasounds Operations Shock 87

ETM Course

JULY 9, 2015

And feel free to run your own trials and let us know if they’re similar or different! For more information on the various types of large bore IV access check out our post on large bore vascular access devices.

Shock 52

Shock Resuscitation 52

RebelEM

MARCH 2, 2023

Click here for Direct Download of the Podcast Paper: Stewart, RAH et al. Based on recent studies, current guidelines recommend that O2 should not be given to non-hypoxemic patients with STEMI or NSTEMI [2,3]. REBEL Cast Ep114 – High Flow O2, Suspected ACS, and Mortality? that was barely statistically significant.

Outcomes 52

Outcomes EMS EKG/ECG Hospitals 52

PulmCCM

JANUARY 2, 2022

Thoughts After reading the COVID STEROID 2 trial, I was immediately reminded of the ANDROMEDA-SHOCK investigation from a few years ago. Download his free textbook here. For example, 28-day and 90-day mortality rates for 6 mg versus 12 mg were 32.3% versus 27.1% versus 32%, respectively. A way a lone a last a loved a long the.

Outcomes 40

Outcomes Hospitals Shock Wellness 40

PulmCCM

SEPTEMBER 9, 2021

With ANDROMEDA-SHOCK-2 enrolling patients, this distinction could become more salient. Download his free textbook here. If performed, the fluid challenge , should precede a bolus, for if the challenge uncovers a preload intolerant heart, the bolus is arguably moot and harmful.

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

Downeast Emergency Medicine

APRIL 26, 2021

When looking at the subgroups with severe shock, there was an 18.5% When stratifying TXA administration time after injury and qualifying shock incidence, there appeared to be a lower 30 d mortality if TXA was given within 1 hour of the incident. MI or stroke). DOES TXA IMPROVE OUTCOMES IN PATIENTS WITH TBI?

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Don't Forget the Bubbles

AUGUST 13, 2023

Explanation NCBI – Febrile seizures The complications following febrile seizures are: epilepsy – increased risk of around 2% following simple febrile seizures and around 5% following complex febrile seizures as compared to 1% of the general population developing epilepsy in future.

Seizures 95

Seizures Pediatrics Dehydration Radiology 95

Don't Forget the Bubbles

JULY 26, 2023

For anyone approaching a structured ABC would be a priority to establish whether shock was present or not. Typical features include: HR >220bpm Narrow complex regular tachycardia P waves difficult to identify In this case there is no shock present so we can proceed to the right branch of the ALSG guideline.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

PulmCCM

NOVEMBER 17, 2023

Download his free textbook here. Mercadal J, Borrat X, Hernández A, Denault A, Beaubien-Souligny W, González-Delgado D et al : A simple algorithm for differential diagnosis in hemodynamic shock based on left ventricle outflow tract velocity-time integral measurement: a case series. References 1. Ultrasound J 2022, 14(1):36.

Operations 132

Operations Ultrasounds Resuscitation Blood Transfusions 132

RebelEM

DECEMBER 19, 2022

This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. REBEL Cast Ep113 – Defibrillation Strategies for Refractory Ventricular Fibrillation Click here for Direct Download of the Podcast Paper: Cheskes S, et al. N Engl J Med.

EMS 52

EMS Shock CPR Resuscitation 52

RebelEM

JUNE 26, 2023

Click here for Direct Download of the Podcast Paper: Bouzat P et al. High-quality studies are needed to determine the utility of this intervention. REBEL Cast Ep118: The PROCOAG Trial – 4F-PCC in Trauma Patients?

Administration 132

Administration Outcomes Resuscitation Radiology 132

Advanced Emergency Nursing from AENJ

MAY 3, 2014

Download from Hindawi Publishing without additional data availability. Committee on Shock. Hugonnot, S., Cossus, J., & De Luca, A. From mouth to mouth to Bag-Valve-Mask ventilation: Evolution and characteristics of actual devices. A review of the literature. Review by French authors of of BVM design and functioning. Farrington, J.

Resuscitation 40

Resuscitation Military Operations Emergency Nursing 40

PHEM Cast

APRIL 10, 2016

There are toolkits available to download, including one specifically written for the prehospital environment with the College of Paramedics, which summarises the recognition and management of sepsis. Arriving by Emergency Medical Services Improves Time to Treatment Endpoints for Patients With Severe Sepsis or Septic Shock. J Emerg Med.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

RebelEM

JANUARY 29, 2024

Click here for Direct Download of the Podcast Paper: Aykan AC et al. Because the lungs receive 100% of cardiac output, it has been hypothesized that a lower dose of thrombolytic therapy may still be effective with a better safety profile [3][4]. REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

Outcomes 124

Outcomes Stroke Hospitals Administration 124

PulmCCM

OCTOBER 16, 2023

Download the central line checklist from John Hopkins here. For example, a patient who presented with shock and mitral regurgitation, received a central line for vasopressors on day 0, and was found to have bacteremia from blood cultures drawn on day 3 due to endocarditis would have a CLABSI, but not a CRBSI.

CDC 52

CDC Hospitals Ultrasounds Documentation/Coding 52

RebelEM

JANUARY 25, 2023

2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

PulmCCM

JANUARY 4, 2022

’ What they found 45 critically-ill patients were included with a 28-day mortality rate of 29%; distributive shock was the most common cause of circulatory failure with sepsis being the most common cause of distributive physiology. Download his free textbook here. ED50] and in 90% [i.e.,

Wellness 40

Wellness Outcomes Sepsis Stroke 40

PulmCCM

SEPTEMBER 23, 2021

Download his free textbook here. Guarracino F, Ferro B, Morelli A, Bertini P, Baldassarri R, Pinsky MR: Ventriculoarterial decoupling in human septic shock. Landesberg G, Gilon D, Meroz Y, Georgieva M, Levin PD, Goodman S et al : Diastolic dysfunction and mortality in severe sepsis and septic shock. Chest 1988, 93(5):903-910.

Stroke 40

Stroke Sepsis Shock Ultrasounds 40

Rural Doctors Net

AUGUST 30, 2013

Imagine being able to stream or access a downloaded 60 sec video file on how to perform a critical procedure – not a tool for novices, but a useful aide memoire for rural clinicians who may only do this stuff once in a blue moon. For the spontaneously breathing patient, there can be significant differences in FiO2.

Burns 52

Burns Hospitals Wellness Ambulance Services 52

Downeast Emergency Medicine

OCTOBER 21, 2021

We chose this topic for Journal Club with the goals to raise awareness around these shocking statistics, discuss etiologies behind these high rates of suicide, and to normalize the discussion around physician mental health. Download article summaries sHANAFELT ET AL. DYRBYE ET AL.

Documentation/Coding 52

Documentation/Coding Emergency Department Shock Research 52

RebelEM

MAY 15, 2024

REBEL Core Cast 122.0 – Neutropenic Fever Click here for Direct Download of the Podcast. Identify low risk patients and send them home with PO antibiotics and close oncology follow-up in conjunction with your oncologist. Give appropriate fluids, vasopressors, and antibiotics.

Infectious Diseases 80

Infectious Diseases Administration Sepsis Anaphylaxis 80

Don't Forget the Bubbles

JULY 5, 2023

Symptoms may be non-specific in the beginning with patients quickly developing septic shock and disseminated intravascular coagulation. Websites [link] [link] [link] [link] Please download our Facilitator and Learner guides The post Sickle Cell Disease Module appeared first on Don't Forget the Bubbles. 2019, 3 rd edition.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Don't Forget the Bubbles

FEBRUARY 14, 2024

We need to focus on Gabriella but also remember her mother – she is likely to be shocked/distressed and will need supporting through this episode too ● Your team need to have a very low threshold for involving social services Gabriella is likely to need a full child protection medical What is your departmental policy on this?

Wellness 105

Wellness Ultrasounds Shock 105