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ToxCard: Iron

EMDocs

Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. 5 Orogastric lavage may also be considered for GI decontamination but likely to be limited by location, size of tablets, and operator familiarity. Basic assessment: airway, breathing, circulation. Antiemetics as needed. 2 L/hr in adults.

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EM@3AM: Stercoral Colitis

EMDocs

Operative management is necessary for signs of peritonitis, evidence of perforation, extensive bowel involvement >40cm, or after failed medical management. 2-4, 6, 8, 9, 12, 13, 14 Operative intervention typically consists of emergency laparotomy with bowel resection, colostomy formation, and Hartmann pouch creation.

EMS 94
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Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS

PulmCCM

Further, the treating clinician must have deemed either normal saline or balanced crystalloid as appropriate resuscitation options; the patient’s expected-admission to the ICU must have been at least 3 days. Other exclusions were imminent risk of death, life-expectancy less than 90 days, traumatic brain injury, risk of cerebral edema.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

In this patient with a penetrating posterior flank injury, trace-free fluid in the pelvis on eFAST, and ongoing signs of hemorrhagic shock despite fluid and blood product administration, transferring to the operating room for exploration is indicated, especially with high probability of zone III injury-related retroperitoneal bleeding.

EMS 93
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The SQuID Protocol: SQ Insulin in DKA?

RebelEM

Background: DKA is traditionally treated with fluid resuscitation, electrolyte replacement, and intravenous infusions of insulin. The SQuID Protocol (Subcutaneous Insulin in /diabetic Ketoacidosis): Impacts on ED Operational Metrics. A more optimal, and promising, solution may be the use of SQ insulin in mild to moderate DKA.

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CICM Second Part Exam Practice SAQs 22082024

Intensive Blog

Outline the initial assessment of severe burns injury, including how you will calculate fluid resuscitation requirements. Outline the key considerations for the early post-operative ICU care of a patient who had open surgery for Type A aortic dissection. Operative course? Show Q3 suggested answer guide Relevant history?

Burns 52
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emDOCs Revamp: Esophageal Perforation

EMDocs

6 Treatment : Airway Definitive airway management should be performed in those with respiratory distress with attention to appropriate resuscitation started beforehand in the setting of potential distributive shock from mediastinitis. 4 Fluid resuscitation and vasopressor use as appropriate.