EMDocs

JULY 13, 2024

We’ll keep it short, while you keep that EM brain sharp. Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis. Incidence, treatment and outcome of peripartum sepsis. Am J Clin Pathol. 1999 Aug;112(2):211-5.

OB/GYN 81

OB/GYN EMS Sepsis Fluid Resuscitation 81

RebelEM

MAY 25, 2023

vs 3U) but no difference in mortality (Study not powered for this outcome) Clinical Take Home Point: The use of vasopressors is controversial and requires a nuanced approach SUMMARY OF MINIMIZING IATROGENIC INJURY RESTORE PERFUSION VOLUME REPLACEMENT Blood Products >>> Crystalloids Holcomb JB et al. NEJM 1994. [2] NEJM 1994. [2]

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

ACEP Now

OCTOBER 3, 2023

These guidelines present the best available evidence to support clinical decision making in the prehospital setting when TBI care may have the most significant impact on outcomes; they also establish a research agenda for future investigations. This document is an update of guidelines first published in 2000, and then updated in 2007.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation EMS 98

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% Welcome back to the “52 in 52” series. This collection of posts features recently published must-know articles.

Sepsis 86

Sepsis Shock Resuscitation Fluid Resuscitation 86

RebelEM

SEPTEMBER 29, 2022

There are also potential harms to large volume fluid resuscitation including progression of pancreatitis and fluid overload with or without respiratory failure. Though the initial recommendation for aggressive fluid resuscitation was not based on substantial evidence, clinicians have been slow to pivot away from this approach.

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

RebelEM

OCTOBER 2, 2023

Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 tests/hr (0.8 Traditional: 1.0 tests/hr (0.8 Pre-Intervention: 1.0

Operations 97

Operations Academics Fluid Resuscitation Outcomes 97

Taming the SRU

MAY 11, 2024

r1 clinical knowledge - r4 capstone - research grand rounds - the art of em - Community corner - PEM Lecture r1 Clinical knowledge: transplant complications WITH dr. gabor Time-sensitive peri-transplant emergencies: Bleeding fistula- stop the bleed. Flood syndrome- start fluids, give antibiotics, consult surgery.

Administration 92

Administration Resuscitation Fluid Resuscitation Research 92

The Skeptics' Guide to EM

JUNE 12, 2022

Case: A 62-year-old man is brought in by EMS from home with lethargy and hypotension. Two large, cluster-randomized trials ( SMART and SALT-ED ) showed a small benefit to the use of balanced crystalloids in preventing a composite outcome of Major Adverse Kidney Events within 30 days (aka MAKE-30). Reference: Finfer et al.

Fluid Resuscitation 53

Fluid Resuscitation Resuscitation Outcomes Administration 53

PHEM Cast

APRIL 10, 2016

And from our buddies at HEFT EM CAST: [link] A bit more detail covering some of the research in an easy to understand way. This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. St Emlyns Induction podcast on Sepsis.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

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. Case: EMS is dispatched to a retirement home. Other serious time-dependent conditions such as myocardial infarction and trauma have been improved significantly with emergency medical services (EMS).

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. There are few data on the outcomes of UGIB when balloon tamponade is used as a temporizing measure. 14 In clinically stable patients who do not require resuscitation, EGD is less urgent and may be performed within six to 24 hours. 6 Balloon tamponade (i.e., Acad Emerg Med.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

EB Medicine

OCTOBER 1, 2018

And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. Jeff : I’m an EMS fellow, what can I say… Anyway, on to my favorite section -- prehospital care. Let’s start with fluids.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

OCTOBER 5, 2024

We’ll keep it short, while you keep that EM brain sharp. 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). IV fluid resuscitation as needed. mcg/kg/min and titrated to MAP >65). 2018;320(10):984–994.

EMS 93

EMS Infectious Diseases Sepsis Hospitals 93

EMDocs

DECEMBER 18, 2023

Today, she would not get out of bed, prompting the facility to call EMS. 8 Based on multiple randomized controlled trials (RCTs), SSC 2021 guidelines suggest against using procalcitonin as a screening method to guide initiation of antibiotic therapy, as no difference in clinical outcomes was appreciated. She had a fever of 38.7 °C

Sepsis 83

Sepsis Fluid Resuscitation Shock Resuscitation 83

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. The post EM@3AM: Hyperthermia appeared first on emDOCs.net - Emergency Medicine Education.

Hyperthermia / Hypothermia 87

Hyperthermia / Hypothermia EMS Stroke Seizures 87

EMDocs

JULY 17, 2023

Measures to optimize the patient for surgical intervention and treat shock, including antibiotics and fluid resuscitation, are associated with improved outcomes in these patients. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. World J Gastroenterol. 2007 Jan 21;13(3):432-7.

Operations 95

Operations EMS Fluid Resuscitation Resuscitation 95

EMDocs

JUNE 27, 2024

Sundd P, Gladwin MT, Novelli EM. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Factors associated with adverse outcome among children with sickle cell disease admitted to the pediatric intensive care unit: an observational cohort.

Pediatrics 94

Pediatrics Dehydration EMS Hospitals 94

EMDocs

JANUARY 20, 2024

We’ll keep it short, while you keep that EM brain sharp. This patient’s recent diarrheal illness raises suspicion for hypovolemia, which would be treated with fluid resuscitation (D) , but her moist oral mucosa and dilated inferior vena cava suggest an eu- or hypervolemic state. J Neurosurg. 2006;105(2):264-270. doi:10.3171/jns.2006.105.2.264

EMS 93

EMS Fluid Resuscitation Shock EKG/ECG 93

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 124

Fluid Resuscitation Resuscitation Documentation/Coding Outcomes 124

EMDocs

JANUARY 20, 2025

One of the hallmarks of sepsis care, based on the Rivers 2001 17 trial and still recommended by the latest SCCM guidelines is early detection of sepsis and initiation of early resuscitation. link] During the 2017 IV fluid shortage, Patino et al. Inwald et al. Choudhari et al.

Dehydration 73

Dehydration Fluid Resuscitation Sepsis Resuscitation 73