RebelEM

FEBRUARY 24, 2025

Well, the established cutoff for the distensibility index is 18%. A cutoff of 18% has a positive predictive value (PPV) of 92% and NPV of 90% for fluid responsiveness. 14,15 You might use a passive leg raise, which carries a roughly 250cc fluid challenge. Why does it matter? Am J Respir Crit Care Med. Jan 2019; PMID: 30138573.

Ultrasounds 74

Ultrasounds Shock Fluid Resuscitation Resuscitation 74

EMDocs

JUNE 25, 2024

Most common traumatic injuries are fractures, TBIs, and thoracic or abdominal injuries. Consider escharotomy if there is any issue with perfusion or neurologic deficit, as well as difficult ventilation in the intubated patient. Calculating fluid resuscitation: Parkland formula: 4 mL X % TBSA X weight in kilograms.

Burns 96

Burns Fluid Resuscitation Resuscitation Poisoning 96

RebelEM

MAY 25, 2023

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. Hypotensive resuscitation during active hemorrhage: impact on in-hospital mortality. NEJM 1994. [2] NEJM 1994. [2] PMID: 12045644 Bickell WH et al.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Taming the SRU

MAY 11, 2024

Flood syndrome- start fluids, give antibiotics, consult surgery. Be careful with fluid resuscitation in renal transplant patients who can be at risk for volume overload. For mid-shaft femur fractures, traction appears to may reduce blood loss and pulmonary complications, but the available data is very scarce.

Resuscitation 93

Resuscitation Administration Fluid Resuscitation Research 93

EB Medicine

NOVEMBER 1, 2018

Nachi: There is a school of thought out there that victims of electrical injury can have delayed onset arrhythmias and require prolonged cardiac monitoring – however several well-designed observational studies, including 1000s of patients, have demonstrated no such evidence. Let’s move on to treatment.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

ACEP Now

MARCH 14, 2024

Treatment for burns should focus on fluid resuscitation as appropriate based on your institution’s burn protocol per Brooke, Parkland, Rule of 10s etc. Lastly, vessels can be damaged by internal burns, which may lead to poor perfusion and delayed complications as thrombosis or third spacing. His ECG was unremarkable.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Taming the SRU

AUGUST 25, 2023

doxycycline Consider a splint/cast window to allow direct monitoring mainly used for fracture blisters and/or open wounds yet takes away from the strength of the splint/cast Case #3 43yo with FOOSH injury and closed wrist deformity, yet no x-ray machine is available to you Least likely injuries to need an x-ray in a resource-limiting setting?

Seizures 76

Seizures Fractures EKG/ECG Resuscitation 76