Download Shock Wellness 
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% Liberal: 14.9%
EM SIM Cases
SEPTEMBER 19, 2024
WHY IT MATTERS Patients in hemorrhagic shock require blood products expeditiously as well as identification and definitive management of the source of bleeding. This case provides an opportunity to practice identification and treatment of multiple sources of blood loss in hemorrhagic shock.
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RebelEM
JUNE 26, 2023
4F-PCC contains factors II, VII, IX, X as well as Proteins S and C. Click here for Direct Download of the Podcast Paper: Bouzat P et al. Some clinicians have advocated for early administration of 4-factor prothrombin complex concentrate (4F-PCC) based on limited observational data. Severe acute traumatic coagulopathy = PT >1.5
Don't Forget the Bubbles
JULY 26, 2023
A cardiac family history should of course be sought, but think a little outside the box as well. For anyone approaching a structured ABC would be a priority to establish whether shock was present or not. We now have a patient who is in sustained SVT but with no features of shock. Family history. What if this does not work?
PulmCCM
JANUARY 4, 2022
As well, the volume of administration might be much lower than 500 mL, with previous research indicating that 4 mL/kg of crystalloid was an optimal volume needed to increase mean systemic filling pressure. Download his free textbook here. ED50] and in 90% [i.e., ED90] of the patients who were ‘responders.’
PulmCCM
SEPTEMBER 9, 2021
And so, Zampieri and colleagues recently released the Balanced Solutions in Intensive Care Study [BaSICS], comparing two types of crystalloid resuscitation fluid, discussed previously , as well as two infusions rates of these fluids , considered below. saline as well as to two different infusion rates of said fluids. hypotension; c.]
RebelEM
JANUARY 25, 2023
Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5
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