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. Of note, HTS is more effective in trauma patients because it is used as a resuscitative fluid as well.

Administration 91

Administration Resuscitation Fluid Resuscitation Research 91

Don't Forget the Bubbles

OCTOBER 7, 2024

The high voltage can cause direct thermal injuries, as well as mechanical injuries from falls or secondary trauma. Prolonged CPR should be considered as outcomes are generally good, even if asystole is the presenting rhythm. In most paediatric cardiac arrests, the primary cause is respiratory – not so in cases of electrocution.

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

Mind The Bleep

OCTOBER 29, 2024

Alkali burns result in liquefaction necrosis, allowing for deeper tissue injury as well as vascular injury that can lead to both local and systemic toxicity [1]. Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

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

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. His immunizations are current and has received all pneumococcal vaccinations. C or 100.4

Pediatrics 75

Pediatrics Dehydration EMS Hospitals 75

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 64

OB/GYN EMS Sepsis Fluid Resuscitation 64

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. older than 65 years; b.]

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

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. Sleep well, endoscopist: January 2021 Annals of Emergency Medicine journal club.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 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. However, if the infant is well-perfused, cardiovascularly stable, and showing no signs of organ dysfunction, active treatment may not be necessary.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

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. There were similar baseline characteristics and the groups were well-matched. versus 59.2%). versus 14.9%

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Taming the SRU

AUGUST 25, 2023

bicarb <18mEq/L) ketosis (preferably serum beta-hydroxybutyrate >3mmol/L) Risk factors SGLT2 inhibitor use fasting state ketogenic diet intra-abdominal pathology (AGE, pancreatitis, etc.) to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75

Don't Forget the Bubbles

JUNE 10, 2024

Baby A, a preterm infant, appears to be faring well for the moment—requiring minimal respiratory support, on full feeds, without IV access, and generally in an okay condition. Welcome to your first day with the neonates! Upon arriving for your initial shift, you set down your bag, and shortly after, you’re asked to evaluate Baby A.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

EB Medicine

OCTOBER 1, 2018

Jeff : So as well all know Sepsis is bread and butter emergency medicine, but, what is sepsis? 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.

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 65

Sepsis Fluid Resuscitation Resuscitation Shock 65

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. They will want daily weights and closely monitored fluid balance.

Fluid Resuscitation 96

Fluid Resuscitation Hospitals Dehydration Research 96

EMDocs

JANUARY 20, 2024

The most common findings on ECG are ST elevation , most often in the anterior precordial leads, as well as sinus tachycardia and QT interval prolongation. Additional fluids will not improve her condition and may worsen it. Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy. J Neurosurg. 2006;105(2):264-270.

EMS 74

EMS Fluid Resuscitation Shock EKG/ECG 74

EMDocs

OCTOBER 5, 2024

ESBL are found exclusively in Gram-negative organisms, including: Klebsiella pneumoniae Klebsiella oxytoca Escherichia coli Proteus mirabilis Pseudomonas aeruginosa The first reported beta-lactamase enzyme was reported in 1963, and today there are well over 350 ESBL enzyme variants. IV fluid resuscitation as needed.

EMS 74

EMS Infectious Diseases Sepsis Hospitals 74