EMDocs

FEBRUARY 20, 2024

Fluids in Pancreatitis #1 : de-Madaria E, Buxbaum JL, Maisonneuve P, et al; ERICA Consortium. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. cc/kg/hour of LR Control: LR Bolus of 20 cc/kg (regardless of fluid status) followed by 3.0 2.18) Fluid Overload: 20.5% 2.18) Fluid Overload: 20.5%

Fluid Resuscitation 98

Fluid Resuscitation Resuscitation Outcomes Hospitals 98

EMDocs

NOVEMBER 29, 2023

EBM Update: Fluids in Pancreatitis, Hypertriglyceridemic Pancreatitis #1: de-Madaria E, Buxbaum JL, Maisonneuve P, et al; ERICA Consortium. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. cc/kg/hour of LR Control: LR Bolus of 20 cc/kg (regardless of fluid status) followed by 3.0 N Engl J Med.

Fluid Resuscitation 94

Fluid Resuscitation Resuscitation Outcomes Hospitals 94

EMDocs

JANUARY 25, 2025

Management is directed based on underlying etiology, but consider fluid resuscitation, antipyretics, and antibiotics as indicated. 0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. An update on the diagnosis and treatment of chronic idiopathic neutropenia.

EMS 96

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 96

EMDocs

JANUARY 11, 2025

If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. Stercoral Colitis in the Emergency Department: A Retrospective Review of Presentation, Management, and Outcomes. Mathis, K. L., & Lindor, R. link] Chakravartty, S.,

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

Mind The Bleep

OCTOBER 29, 2024

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications. Proper stabilization and detailed communication with the burns centre are essential for optimal patient outcomes.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

Don't Forget the Bubbles

FEBRUARY 5, 2025

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. Establish IV access for potential fluid resuscitation. You feel the patient needs fluid resuscitation.

Fluid Resuscitation 59

Fluid Resuscitation Domestic Violence Head Injuries Sexual Assault 59

PulmCCM

FEBRUARY 28, 2022

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. Death, from any cause, within 90 days of randomization was the primary outcome.

Fluid Resuscitation 40

Fluid Resuscitation Resuscitation Outcomes Sepsis 40

ACEP Now

OCTOBER 29, 2024

In such cases, would you wait for a lactate, white blood cell count, bandemia, or other diagnostics to confirm a source of infection before starting antibiotics, fluid resuscitation, and/or pressors? In this study, clinical gestalt is not only fast, but accurate for the benefit of timely resuscitation and intervention.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

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% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 95

Sepsis Shock Resuscitation Fluid Resuscitation 95

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 103

Operations Academics Fluid Resuscitation Outcomes 103

EMDocs

SEPTEMBER 7, 2024

The time taken to measure serum hemoglobin and hematocrit (B) and await a result would delay definitive surgical control of likely ongoing hemorrhage given this patient’s incomplete response to fluid resuscitation. Spontaneous retroperitoneal hematoma: etiology, characteristics, management, and outcome. J Emerg Med. 2011.06.006.

EMS 98

EMS Fluid Resuscitation Resuscitation Radiology 98

EMDocs

MAY 15, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Hypervolemia – leads to pulmonary edema: Consider diuresis If euvolemic – start maintenance fluids of D5 in 0.45%NS Causes and outcomes of the acute chest syndrome in sickle cell disease. times maintenance.

Blood Transfusions 104

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 104

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

Don't Forget the Bubbles

NOVEMBER 27, 2023

So, fluid has been tried but has not got close to fixing the problem. In middle-to-high-income countries, after 40-60ml/kg of fluid resuscitation, the Surviving Sepsis Campaign International Guidelines recommend using vasoactive drugs. The wide pulse pressure and transient response would suggest an afterload problem.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

EMDocs

MAY 28, 2024

Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. If euvolemic – start maintenance fluids of D5 in 0.45%NS Causes and outcomes of the acute chest syndrome in sickle cell disease. Decreases splinting and improves tidal volumes. times maintenance. Am J Emerg Med. N Engl J Med.

Blood Transfusions 98

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 98

The Skeptics' Guide to EM

JUNE 12, 2022

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). There was no interaction between fluid type or rate of infusion with the primary outcome of 90-day survival.

Fluid Resuscitation 53

Fluid Resuscitation Resuscitation Outcomes Administration 53

Dr. Smith's ECG Blog

AUGUST 2, 2024

the investigators reviewed outcomes in 118 patients presenting with NSTEMI. Yet recognition of acute RV MI is extremely important clinically — because emergency treatment will often require different priorities (ie, avoidance of nitroglycerine; fluid resuscitation for hypotension ). 118.007305) from Heitner et al. ,

EKG/ECG 119

EKG/ECG Fluid Resuscitation Academics Resuscitation 119

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. Have a high suspicion for infection in transplant patients. Immunosuppression can blunt the typical immune response.

Resuscitation 92

Resuscitation Administration Fluid Resuscitation Research 92

Don't Forget the Bubbles

OCTOBER 7, 2024

Prolonged CPR should be considered as outcomes are generally good, even if asystole is the presenting rhythm. Judicious fluid resuscitation is critical; patients may become volume-deplete due to fluid loss/oedema secondary to burns.

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

EMDocs

JULY 13, 2024

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. Plasma cell endometritis is associated with Chlamydia trachomatis infection. Am J Clin Pathol. PMID: 10439801.

OB/GYN 91

OB/GYN EMS Sepsis Fluid Resuscitation 91

EMDocs

NOVEMBER 20, 2023

Hemodynamic resuscitation Key Concept: Patients with hemodynamic instability and/or suspected ongoing bleeding should receive intravenous fluid resuscitation with the goal of optimization of blood pressure and heart rate before endoscopic evaluation/intervention. (Conditional recommendation, low-quality evidence).

Resuscitation 104

Resuscitation Fluid Resuscitation Hospitals Research 104

PHEM Cast

APRIL 10, 2016

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. Prehospital intravenous access and fluid resuscitation in severe sepsis: an observational cohort study. Academic Emergency Medicine. 2014 Oct 28;:1–9.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

ACEP Now

OCTOBER 9, 2024

In the emergency department (ED), physicians face the challenge of making rapid decisions that can significantly impact patient outcomes. However, the persistence of tachycardia despite fluid resuscitation and dosing with lorazepam to help with his panic disorder raised concerns that warranted further investigation.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Ultrasounds Burns 52

Emergency Medicine Ireland

APRIL 4, 2022

The scheduled, usually elective nature of cardiac surgery lends itself to large scale outcome prediction and indeed, cardiac surgery has found its outcomes examined very closely over the past few decades. Likely driven by rewarming induced vasodilation and hypothermia induced diuresis they can be hypovolaemic.

Fluid Resuscitation 40

Fluid Resuscitation Hyperthermia / Hypothermia Outcomes Resuscitation 40

ACEP Now

OCTOBER 11, 2024

1,2 Clinical outcomes in submersion injuries are largely dependent on the degree of hypoxic injury experienced by the victim, making prehospital care of paramount importance. Fluid resuscitation will likely be warranted, and with crystalloid solution is most appropriate. pediatric hospitals. Acad Pediatr. 2024;24(4):677-685.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

The Skeptics' Guide to EM

FEBRUARY 17, 2018

Intervention: Ceftriaxone 2g IV * Control: Usual care (fluid resuscitation and supplementary oxygen) * Outcome: * Primary: All-cause mortality at 28 days

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

Northwestern EM Blog

FEBRUARY 14, 2022

The primary outcome of the study was the response in MAP three hours after the start of angiotensin II infusion. It showed improvement in blood pressure which is a clinically important parameter but not a patient-oriented outcome. However, one limitation of the study was that it was underpowered to demonstrate a mortality difference.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

Mind The Bleep

FEBRUARY 27, 2024

There could be any number of reasons for this but some examples are: they have severe D&V and aren’t keeping fluids down, or because they are pre or post-op, or have presented very unwell and need fluid resuscitation. saline + 5% dextrose or plasma-lyte 148 + 5% dextrose. Boluses were given in 20-40ml/kg aliquots.

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Hospitals Research 96

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. Outcomes in variceal hemorrhage following the use of a balloon tamponade device. Patients should be assessed for evidence of hypovolemia or active exsanguination. Acad Emerg Med.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

Taming the SRU

MAY 5, 2023

The CLASSIC trial is a randomized controlled trial conducted in the ICU setting which compared restrictive versus standard fluid strategies with a primary outcome of death by 90 days in patients with septic shock. Safety outcomes Serious adverse event occurrences were similar in both groups. versus 59.2%). versus 14.9%

Sepsis 52

Sepsis Shock Administration Resuscitation 52

PulmCCM

SEPTEMBER 9, 2021

Septic sheep randomized to early, rapid volume resuscitation had greater vasopressor requirements 12 hours after initial fluid bolus. It is suggested that rapid, fluid resuscitation generates an abrupt rise in atrial natriuretic peptide, shears the glycocalyx which then impairs vascular reactivity. more than 2].

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

Don't Forget the Bubbles

MARCH 18, 2024

She receives fluid resuscitation, and you organise some tests to find out why she is so tired. Early Volume Expansion and Outcomes of Hemolytic Uremic Syndrome. Treatment and outcome of Shiga-toxin-associated hemolytic uremic syndrome (HUS). 4-year-old Stephanie presents with vomiting, diarrhoea, and lethargy.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Don't Forget the Bubbles

JUNE 10, 2024

Despite advancements in neonatal care, NEC remains a significant concern due to its association with adverse outcomes, including prolonged hospitalisation, the need for surgical intervention, and increased mortality rates. What is the pathophysiology of necrotising enterocolitis? How do you treat necrotising enterocolitis? Can we prevent NEC?

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

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. Let’s start with fluids. Patient’s need adequate fluid resuscitation. So quite a few changes!

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

DECEMBER 18, 2023

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. 15 Two changes were elucidated in the 2021 SSC guidelines for fluid resuscitation.

Sepsis 93

Sepsis Fluid Resuscitation Resuscitation Shock 93

EMDocs

JANUARY 20, 2024

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. Additional fluids will not improve her condition and may worsen it. J Neurosurg. 2006;105(2):264-270.

EMS 102

EMS Fluid Resuscitation Shock EKG/ECG 102