Remove Fluid Resuscitation Remove Outcomes Remove Radiology
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ToxCard: Iron

EMDocs

7 Workup other than serum iron concentration at 4 hours after ingestion not shown to accurately predict clinical outcomes or severity of toxicity. Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Radiology in the management of acute iron poisoning. Antiemetics as needed. Hosking CS.

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Trauma Resuscitation Updates

RebelEM

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]

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Major Trauma – Injuries by Assault

Don't Forget the Bubbles

This should include early identification of life-threatening injuries, targeted fluid resuscitation using blood products, pain management, then eventual safeguarding and psychological support. E.g. burns, neurosurgery, interventional radiology. Establish IV access for potential fluid resuscitation.

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EM@3AM: Retroperitoneal Hematoma

EMDocs

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 93
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Guideline Update: Acute Lower GI Bleeding

EMDocs

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).