Mind The Bleep

OCTOBER 29, 2024

Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. This includes adequate pain control, fluid resuscitation, and stabilization of any systemic complications. Check temperature and blood glucose levels.

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Burns Fluid Resuscitation PPE Resuscitation 52

Don't Forget the Bubbles

NOVEMBER 18, 2024

Research and guidelines from Australian centres, like those published by the Australian and New Zealand Neonatal Network (ANZNN), emphasize early detection and management to improve outcomes. Before considering fluid resuscitation or inotropes, it is essential to correct the infant’s body temperature. and Roberts, N.

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Sepsis Shock Hyperthermia / Hypothermia Administration 57

Northwestern EM Blog

FEBRUARY 14, 2022

The ATHOS-3 trial in 2017 explored the efficacy of angiotensin II as a vasopressor for severe vasodilatory shock. Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation.

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Shock Resuscitation Fluid Resuscitation Sepsis 52

Taming the SRU

MAY 5, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. N Engl J Med. 2023;388(6):499-510. 2021, Jarczak, Kluge et al.

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Sepsis Shock Administration Resuscitation 52

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. 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.

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Sepsis Shock Fluid Resuscitation Hospitals 40

PulmCCM

MAY 22, 2023

Early mobilizers got significantly more exercise, but had no improvement in any clinical outcome (days alive outside the hospital, ventilator-free days, ICU-free days, or cognitive or psychological function). At least one expert questioned whether the study was adequately powered. In an NHLBI-sponsored trial enrolling 1563 patients at 60 U.S.

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Fluid Resuscitation Resuscitation Hospitals Sepsis 64

EMDocs

JULY 17, 2023

Measures to optimize the patient for surgical intervention and treat shock, including antibiotics and fluid resuscitation, are associated with improved outcomes in these patients. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. World J Gastroenterol.

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Operations EMS Fluid Resuscitation Resuscitation 78

EMDocs

JUNE 27, 2024

Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Factors associated with adverse outcome among children with sickle cell disease admitted to the pediatric intensive care unit: an observational cohort. C or 100.4 mg/kg, max 0.4

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Pediatrics Dehydration EMS Hospitals 76

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. Arriving by Emergency Medical Services Improves Time to Treatment Endpoints for Patients With Severe Sepsis or Septic Shock. 2009;13(5):R167. 2014 Oct 28;:1–9.

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Sepsis Fluid Resuscitation Resuscitation Emergency Department 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].

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Resuscitation Fluid Resuscitation Sepsis Outcomes 40

EMDocs

DECEMBER 18, 2023

Septic shock is high on the differential diagnosis for this patient’s presentation. Introduction Sepsis and septic shock are life-threatening conditions characterized by severe systemic inflammation and organ dysfunction due to a dysregulated host response to infection. What are the most up-to-date guidelines for managing this patient?

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Sepsis Fluid Resuscitation Resuscitation Shock 66

EMDocs

JANUARY 20, 2024

Symptoms of heart failure and cardiogenic shock may develop in more severe cases. Answer: Takotsubo Cardiomyopathy 1-18 Background: Also known as transient apical ballooning syndrome, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, stress cardiomyopathy, Gebrochenes-Herz syndrome, and broken-heart syndrome.

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EMS Fluid Resuscitation Shock EKG/ECG 75

EMDocs

OCTOBER 5, 2024

Management 9-12 Patients such receive standard resuscitation care including: Antipyretics such as Tylenol (650-1000 mg PO), Ibuprofen (600 mg PO), or Toradol (15mg IV). IV fluid resuscitation as needed. Pressors where indicated for septic shock (typically Norepinephrine starting at 0.05

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EMS Infectious Diseases Sepsis Hospitals 74

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.

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Fluid Resuscitation Hospitals Dehydration Research 96

EMDocs

DECEMBER 16, 2023

Heat stroke can lead to end-organ dysfunction such as rhabdomyolysis, disseminated intravascular coagulation, cardiogenic shock, liver failure, and cerebral edema. Broad-spectrum antibiotics (A) for septic shock are not inappropriate given the hyperthermia, tachycardia, and hypotension. Temps greater than 41.5C link] Swee, duS.,

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Hyperthermia / Hypothermia EMS Stroke Seizures 69