EMDocs

JULY 17, 2023

Bowel perforation demonstrated by CT, hard signs of peritonitis, or an overall toxic appearance warrant emergent surgical consultation. Measures to optimize the patient for surgical intervention and treat shock, including antibiotics and fluid resuscitation, are associated with improved outcomes in these patients.

Operations 77

Operations EMS Fluid Resuscitation Resuscitation 77

The Skeptics' Guide to EM

FEBRUARY 17, 2018

Case: EMS is dispatched to a retirement […] The post SGEM#207: Ahh (Don’t) Push It – Pre-Hospital IV Antibiotics for Sepsis. first appeared on The Skeptics Guide to Emergency Medicine. Case: EMS is dispatched to a retirement home. Jenn Doyle is a paramedic educator at Middlesex-London Paramedic Service.

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

EMDocs

JUNE 27, 2024

Sundd P, Gladwin MT, Novelli EM. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02 mg/kg, max 0.4 Am J Hematol.

Pediatrics 75

Pediatrics EMS Dehydration Hospitals 75

Broome Docs

OCTOBER 31, 2022

PMID: 34904190 Not surprisingly, this paper has been covered by basically everyone who talks about research, so if you want to hear some other opinions, check out the SGEM , REBEL EM , or St. PMID: 30206143 Less is more when it comes to intravenous fluids de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Emerg Med J. N Engl J Med.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

EMDocs

JULY 30, 2024

Treat the DKA as you would with any other patient; insulin, appropriate fluid resuscitation, and electrolyte repletion. Niacin has been used but has a lower bioavailability than nicotinamide and can cause hypotension when given. Orthostatic hypotension can persist for months after ingestion.

Poisoning 56

Poisoning Seizures Fluid Resuscitation Pediatrics 56

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. 14 In clinically stable patients who do not require resuscitation, EGD is less urgent and may be performed within six to 24 hours. Dr. Matthew Turner , originally trained at the Medical University of South Carolina, is an EM intern at Hershey Medical Center in Hershey, Pa.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

EMDocs

OCTOBER 7, 2023

We’ll keep it short, while you keep that EM brain sharp. A 17-year-old girl, in moderate distress, is brought in by EMS after a motor vehicle collision. EMS reports that she was “pinned” underneath the dashboard, and it took several hours to extricate her.

EMS 73

EMS Fluid Resuscitation Fractures Resuscitation 73

EMDocs

JANUARY 20, 2024

We’ll keep it short, while you keep that EM brain sharp. Takotsubo syndrome is often exceedingly difficult to distinguish from acute myocardial infarction in the emergency department, as there is significant overlap in many clinical and diagnostic features. Vital signs show T of 99.0°F

EMS 74

EMS Fluid Resuscitation Shock EKG/ECG 74

EMDocs

OCTOBER 5, 2024

We’ll keep it short, while you keep that EM brain sharp. A 62-year-old female patient with a history of recurrent urinary tract infections (UTIs) presents to the emergency department with fever, chills, and dysuria. IV fluid resuscitation as needed. mcg/kg/min and titrated to MAP >65). 2018;320(10):984–994.

EMS 74

EMS Infectious Diseases Sepsis Hospitals 74

EMDocs

DECEMBER 18, 2023

Today, she would not get out of bed, prompting the facility to call EMS. 13,14 Fluids Fluid resuscitation is a mainstay of sepsis therapy, as the condition is commonly associated with both absolute and relative hypovolemia. 15 Two changes were elucidated in the 2021 SSC guidelines for fluid resuscitation.

Sepsis 65

Sepsis Fluid Resuscitation Resuscitation Shock 65

EMDocs

DECEMBER 16, 2023

We’ll keep it short, while you keep that EM brain sharp. A 34-year-old male is brought via EMS after collapsing during an outdoor adventure race. EMS reports the patient was conscious but altered, with slurred speech and confusion. An 18-month-old boy presents to the emergency department with loss of consciousness.

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68

EMDocs

MARCH 11, 2024

Authors: Gaston Omba, MD (EM Resident Physician, Makerere University); Jessica Pelletier, DO (EM Education Fellow, Washington University in St. Patients who cannot tolerate oral intake of fluids should receive intravenous (IV) fluid resuscitation but are encouraged to start drinking ORS as soon as they are able.

Dehydration 90

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 90

The Skeptics' Guide to EM

JUNE 15, 2018

Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.

Emergency Department 52

Emergency Department Fluid Resuscitation Hospitals Sepsis 52

EMDocs

JANUARY 20, 2025

Much of our understanding of the clinical signs of hypovolemia comes from studies performed on phlebotomy volunteers 1,2 while our understanding of fluid overload comes from heart failure patients. For patients without frank signs of shock, it is reasonable to trial oral hydration prior to moving on to IV fluids. Acad Emerg Med.

Dehydration 50

Dehydration Fluid Resuscitation Sepsis Resuscitation 50