The Skeptics' Guide to EM

NOVEMBER 12, 2022

Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL). Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University. Guest Skeptic: Dr. Salim R.

Fluid Resuscitation 52

Fluid Resuscitation Resuscitation Emergency Department Shock 52

RebelEM

SEPTEMBER 29, 2022

Background: Standard emergency department management of acute pancreatitis has focused on aggressive hydration, analgesia and investigation for an underlying reversible cause (eg gallstones). Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis (WATERFALL). Article: de-Madaria E et al. cherry picking results).

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

Dr. Smith's ECG Blog

OCTOBER 26, 2010

He presented to the Emergency Department with a blood pressure of 111/66 and a pulse of 117. 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. He had this ECG recorded. The HCO3 was 8.

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

Northwestern EM Blog

MAY 9, 2022

There is no gold standard with respect to its definition, and it requires a medication history (which we typically don't do very well in the emergency department). Therefore, fluid resuscitation and maintenance are important. NMS is hard to diagnose because it's rare.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Emergency Department 52

EB Medicine

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. Jeff: Vascular injuries include coagulation necrosis as well as thrombosis. Jeff: You’re right.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Taming the SRU

JANUARY 12, 2024

r4 case follow up - r1 clinical knowledge: interstitial lung disease - halo - pediatric simulation - pediatric small groups r4 case follow up WITH dr. yates Psychiatric emergency department visits are on the rise in the United States, with roughly 15-19% of all ED visits associated with mental health diagnoses Roughly twenty percent of patients presenting (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

Mind The Bleep

APRIL 26, 2024

For all patients who come into the emergency department with a swelling, it is helpful to know if they have seen their GP or dentist recently and if they have had any treatment or recent courses of antibiotics. 2015) ‘Emergency Department’, in On-call in Oral and Maxillofacial Surgery.

Emergency Department 52

Emergency Department Fluid Resuscitation Dehydration Resuscitation 52

Taming the SRU

APRIL 10, 2023

HOSPITAL COURSE The patient was initially found to be hypotensive in the Emergency Department with a blood pressure of 87/58 mmHg. He was given an intravenous fluid bolus with minimal improvement in his blood pressure, but remained alert. J-point elevation in leads I, II, III, aVF, V5, V6.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Administration 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. Electrical injuries in the emergency department: an evidence-based review. Emerg Med Pract.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis. Acad Emerg Med. Am J Emerg Med. Sleep well, endoscopist: January 2021 Annals of Emergency Medicine journal club. 2010;17(2):126-32.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

Taming the SRU

MAY 5, 2023

doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. RESULTS A total of 1,563 patients were enrolled with 782 assigned to the restrictive and 781 assigned to the liberal fluid groups.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

EMDocs

DECEMBER 18, 2023

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. The patient currently resides at a skilled nursing facility.

Sepsis 93

Sepsis Fluid Resuscitation Resuscitation Shock 93

EMDocs

JANUARY 20, 2024

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. Additional fluids will not improve her condition and may worsen it. Vital signs show T of 99.0°F

EMS 102

EMS Fluid Resuscitation Shock EKG/ECG 102

EMDocs

OCTOBER 5, 2024

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. Management 9-12 Patients such receive standard resuscitation care including: Antipyretics such as Tylenol (650-1000 mg PO), Ibuprofen (600 mg PO), or Toradol (15mg IV).

EMS 98

EMS Infectious Diseases Sepsis Hospitals 98

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. His immunizations are current and has received all pneumococcal vaccinations. C or 100.4

Pediatrics 98

Pediatrics Dehydration EMS Hospitals 98

RebelEM

DECEMBER 23, 2024

VOE is often complicated by hypovolemia, making fluid administration a common intervention ( Lovett 2017 ). saline (NS) solutions are both isotonic crystalloids widely used for intravenous fluid resuscitation across many contexts and disease states ( Myburgh 2013 ). Lactated Ringer (LR) and 0.9% JAMA Intern Med.

Fluid Resuscitation 128

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 128

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. 6-8 In patients who are on long-term hemodialysis, typical non-invasive signs of volume assessment seem to be unreliable as well.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Taming the SRU

MARCH 3, 2025

Because of this, emergency department (ED) physicians need to maintain a high index of suspicion for inhalation injury in the case of any exposure to smoke or fire, especially in closed or small space exposures. Upper Airway Injury to the upper airway, defined as airway structures proximal to the glottis (i.e.

Burns 52

Burns Fluid Resuscitation Emergency Department Resuscitation 52

Don't Forget the Bubbles

FEBRUARY 17, 2025

1] Fred is a 3-year-old boy who presents to the emergency department. Venous Congestion in Adult Critical Care In adults, venous congestion is a well-recognized contributor to organ dysfunction in many conditions, including septic shock and heart failure. J Emerg Trauma Shock, 2021. Kusumastuti, N.P., Latief, and A.H.

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78

Don't Forget the Bubbles

NOVEMBER 18, 2024

The other important moment to always think of the heart (sorry, cardiologists, I don’t think about the heart 24/7) is when a collapsed neonate presents to your emergency department, especially if blood pressure is present. This is one of the situations where you must not forget to feel for femoral pulses.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

EMDocs

MARCH 11, 2024

Louis) // Reviewed by: Joshua Lowe, MD (EM Staff Physician, USAF); Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 25-year-old woman presented to the emergency department (ED) in Uganda with acute encephalopathy. Clinicians should switch from IV hydration to ORS once hydration is improved and the patient can drink.

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111