Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Taming the SRU

MAY 5, 2023

This trial involved employing a restrictive versus standard strategy with the restrictive fluid strategy permitting fluid boluses only when the patient met one of several criteria, whereas the standard fluid strategy had no limit to fluid quantity administered. Mortality at 90 days was equivocal between groups (42.3%

Sepsis 52

Sepsis Shock Administration Resuscitation 52

EB Medicine

NOVEMBER 1, 2018

It was peer reviewed by Dr. O’Keefe and Dr. Silverberg from Florida State University College of Medicine and Kings County Hospital, respectively. In at least one study, the incidence of DVT in hospitalized burn patients was as high as 23%. Jeff: Real quick – in case you missed it – ultrasound sneaks in again. That’s -- high.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

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. Additionally, the recommendation to use a 30 cc/kg bolus was downgraded.

Sepsis 83

Sepsis Fluid Resuscitation Shock Resuscitation 83

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. 1997;42(3):470-475; discussion 475-476.

EMS 92

EMS Fluid Resuscitation Fractures Resuscitation 92

EMDocs

JULY 17, 2023

3 Point of care ultrasound (POCUS) can be highly sensitive for free fluid and pneumoperitoneum when used by a trained physician in the appropriate patient population. 13 Depending on the hospital staffing, this may be a gastroenterology consult or a surgical consult. Otherwise, it is usually managed surgically within a few days.

Operations 95

Operations EMS Fluid Resuscitation Resuscitation 95

EMDocs

JANUARY 20, 2024

Bedside ultrasound shows hypokinesis of the basal portion of the left ventricle with an apparent sigmoid-shaped septum and a dilated inferior vena cava. Ultrasound findings can show bulging of the interventricular septum into the LVOT , which can be interpreted as a sigmoid-shaped septum on bedside evaluation. The oral mucosa is moist.

EMS 93

EMS Fluid Resuscitation Shock EKG/ECG 93

EMDocs

JANUARY 20, 2025

Over the last few years, however, ultrasound has been increasingly playing an important role in the conversation with multiple studies looking at using ultrasound to predict fluid responsiveness in septic patients – for example, using the velocity time integral with passive leg raise. Tullo et al. Tullo et al.

Dehydration 73

Dehydration Fluid Resuscitation Sepsis Resuscitation 73

Don't Forget the Bubbles

FEBRUARY 17, 2025

He has been started on timely broad-spectrum antibiotics according to hospital protocol. He has had some additional episodes of hypotension post-intubation, which is treated with further volume resuscitation. Before considering a further fluid bolus, you do a point-of-care ultrasound (POCUS). J Ultrasound Med, 2023.

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78