ACEP Now

OCTOBER 29, 2024

Caring for critically ill patients with limited information requires snap assessments and judgements for timely resuscitation and efficient emergency department throughput. In this study, clinical gestalt is not only fast, but accurate for the benefit of timely resuscitation and intervention. Sound familiar?

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

EMDocs

MAY 15, 2024

ECG: Evaluate for ischemia, right heart strain. Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Hypervolemia – leads to pulmonary edema: Consider diuresis If euvolemic – start maintenance fluids of D5 in 0.45%NS Overestimates arterial oxygen saturation.

Blood Transfusions 78

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 78

Dr. Smith's ECG Blog

MAY 5, 2022

Fluid resuscitation was initiated. Here is the initial ED ECG: What do you think? The ECG shows peaked T waves, QRS widening, a coved-type ST segment with inverted T waves most prominent in V1 and V2 consistent with Brugada pattern. They opined that the ECG could instead be "metabolic." Creatinine elevated at 3.09

EKG/ECG 52

EKG/ECG Fluid Resuscitation EMS Shock 52

EMDocs

MAY 28, 2024

ECG: Evaluate for ischemia, right heart strain. Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. If euvolemic – start maintenance fluids of D5 in 0.45%NS Overestimates arterial oxygen saturation. Up to 3x less accurate in black patients. times maintenance.

Blood Transfusions 76

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 76

Taming the SRU

APRIL 10, 2023

UDS : positive for amphetamines, benzodiazepines, fentanyl, THC EKG : Normal sinus rhythm, incomplete right bundle branch block, normal axis, normal intervals. He was given an intravenous fluid bolus with minimal improvement in his blood pressure, but remained alert. Diagnostics WBC : 8.6 Plt : 190 Na : 136 K : 4.4 TSH : 18.04

EKG/ECG 52

EKG/ECG Fluid Resuscitation Administration Emergency Department 52

Taming the SRU

AUGUST 25, 2023

to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75

ACEP Now

MARCH 14, 2024

1,4-5 Thus, an electrocardiogram (ECG) and cardiac monitoring should be performed for unstable, electrical injury patients. Treatment for burns should focus on fluid resuscitation as appropriate based on your institution’s burn protocol per Brooke, Parkland, Rule of 10s etc. His ECG was unremarkable.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

EMDocs

NOVEMBER 1, 2023

ECG – May show tachycardia or rate related ST depressions Laboratory evaluation: CBC w/ differential – may reveal leukocytosis with left shift CMP, Lipase – can reveal alternative intra-abdominal diagnoses as well as show findings of end-organ hypoperfusion (elevated serum creatinine, transaminitis, etc.)

Operations 67

Operations Radiology Radiology Fluid Resuscitation 67

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

An immediate 12-lead EKG was obtained: There is ST elevation in leads aVR and V1, with marked ST depression in I, II, III, aVF, V3-V6. In addition, the patient received 750 mL of fluid resuscitation with transient improvement of blood pressure. What should be done? Should the cath lab be activated?

EKG/ECG 52

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 52

Dr. Smith's ECG Blog

OCTOBER 26, 2010

He had this ECG recorded. He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. But, remember, we do not evaluate and treat ECGs, we evaluate and treat patients. The K returned at 6.9

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

PHEM Cast

APRIL 10, 2016

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).

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Mind The Bleep

DECEMBER 31, 2023

For IV fluid requirements, be gentle and cautious, especially in dialysis patients. Again, ask your registrar or consultant if you are unsure about fluid resuscitation/balance/maintenance in renal patients. or the patient is symptomatic or shows signs of hypokalaemia (ECG changes, weakness, arrhythmias).

Fluid Resuscitation 52

Fluid Resuscitation Hospitals Sepsis EKG/ECG 52

EMDocs

JULY 19, 2023

8 As always, remember to correct electrolyte abnormalities and provide fluid resuscitation as indicated. Mercury, in all forms, reacts with sulfhydryl groups in intracellular sites ultimately interfering with multiple enzymatic processes.

Poisoning 66

Poisoning Fluid Resuscitation Administration Seizures 66

ACEP Now

FEBRUARY 11, 2024

This patient’s syncope is most likely due to metabolic disruptions and fluid-status physiology; nevertheless, assessment of cardiogenic etiologies through an EKG, troponin, and cardiac risk factors should be considered as appropriate.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

EB Medicine

NOVEMBER 1, 2018

Thankfully, that gentleman was successfully resuscitated despite no bystander CPR, and if you listen carefully, we hope to arm you with the tools to do so similarly. Those with low voltage injuries and a normal EKG do not require monitoring. Nachi: First off -- I know we’ve said it, but it’s definitely worth reiterating.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EMDocs

OCTOBER 7, 2023

neurologic damage and thrombosis) 20,21 Resuscitation Lactated ringers > Normal saline due to reduced need for urinary alkalinization 22 Place foley and target urine output >300 mL/hr Electrolyte abnormalities Hyperkalemia: Obtain an ECG Stabilization: Calcium gluconate 2 g over 5-10 min.

EMS 74

EMS Fluid Resuscitation Fractures Resuscitation 74

EMDocs

JANUARY 20, 2024

ECG shows ST-segment elevation in V3-V6 only with depression in aVR. Initial vital signs include BP of 157/80, HR of 96, RR 14, SpO2 of 97% on RA, T 37.5. On exam, she is clutching her chest and is in acute distress due to pain with no other remarkable findings. Initial troponin is mildly elevated.

EMS 75

EMS Fluid Resuscitation Shock EKG/ECG 75

EMDocs

DECEMBER 16, 2023

A 12-lead EKG shows sinus tachycardia but is otherwise normal. Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. Resuscitation. , 148 , 173–190. Temps greater than 41.5C Temps greater than 41.5C Epstein, J.,

Hyperthermia / Hypothermia 69

Hyperthermia / Hypothermia EMS Stroke Seizures 69