Critical Care Now

JUNE 30, 2024

The latest Surviving Sepsis Campaign (SSC 2021) guidelines say the following about albumin in in sepsis: The lack of proven benefit and higher cost of albumin compared to crystalloids contributed to our strong recommendation for the use of crystalloids as first-line fluid for resuscitation in sepsis and septic shock.

Sepsis 52

Sepsis Fluid Resuscitation Shock Resuscitation 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. .

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Hospitals Research 96

Pediatric EM Morsels

JULY 28, 2023

Cerebral edema is the most feared emergent complication of pediatric diabetic ketoacidosis. The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. Pediatr Diabetes. The mortality rate for cerebral edema is 21%–24%.

Fluid Resuscitation 246

Fluid Resuscitation Pediatrics Resuscitation Research 246

EMDocs

DECEMBER 6, 2024

Ferrous sulfate tablets are radiopaque and can be visualized on radiographs, however not all preparations are radiopaque (pediatric chewable and liquid preparations). Aggressive fluid resuscitation as patients may be severely hypovolemic from GI symptoms. Arch Pediatr Adolesc Med. 1 Obtain a single view abdominal x-ray.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

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.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

ACEP Now

OCTOBER 11, 2024

Pediatric submersion injuries are one of the leading causes of preventable morbidity and mortality in the pediatric population. percent of pediatric drowning patients with clinically significant traumatic injuries, with intracranial injuries being the most common. 9,11 As with many pediatric issues, prevention is key.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Resuscitation 52

EMDocs

JUNE 25, 2024

Fluid resuscitation target and fluid Fluid resuscitation is one of the most important parts of management; goal is to increase intravascular volume and ensure end organ perfusion. Typically for adults with a TBSA of at least 20% or 10% in pediatric patients. May be associated with fluid overload.

Burns 96

Burns Fluid Resuscitation Resuscitation Poisoning 96

ACEP Now

OCTOBER 3, 2023

Fluid Resuscitation Intravenous fluids should be administered in the prehospital setting to treat hypotension and/or limit hypotension to the shortest duration possible. Hypotensive patients should be treated with blood products and/or isotonic fluids in the prehospital setting.

Fluid Resuscitation 98

Fluid Resuscitation Documentation/Coding Resuscitation Pediatrics 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 times maintenance. Can decrease rate when they are tolerating PO.

Blood Transfusions 103

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 103

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 There are a variety of triggers, including infection (most common in pediatric patients), fat embolism, vaso-occlusive pain crisis, pulmonary embolism, and others.

Blood Transfusions 97

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

EMDocs

JULY 30, 2024

Treat the DKA as you would with any other patient; insulin, appropriate fluid resuscitation, and electrolyte repletion. Case Follow-up: The patient was admitted to the pediatric intensive care unit. Clinical Pediatrics. Orthostatic hypotension can persist for months after ingestion. Fortunately, PNU poisoning is rare.

Poisoning 74

Poisoning Seizures Fluid Resuscitation Pediatrics 74

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. Validity Evidence for a Team-Leading Assessment Tool in Pediatric Emergency Resuscitation Using Video Review (Hartwell et al.)

Resuscitation 93

Resuscitation Administration Fluid Resuscitation Research 93

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. In France, another large randomised controlled trial of Eculizumab in typical HUS – ECULISHU ( Ecul izumab in S higa-toxin Related Hemolytic and U remic S yndrome Pediatric Patients) – has just finished. Pediatr Nephrol.

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

Don't Forget the Bubbles

JUNE 10, 2024

Initial Management Supportive Care : Initial management involves stabilising the infant, which includes fluid resuscitation, cessation of enteral feeds, and provision of total parenteral nutrition (TPN) to rest the bowel and meet the nutritional needs of the infant. Pediatric Clinics of North America, 64(1), 1-15. Battersby, C.,

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

EB Medicine

NOVEMBER 1, 2018

Nachi: Additionally, for those with severe electrical injuries, an IV should be placed and fluid resuscitation should begin. Fluid requirements will likely be higher than those predicted by the parkland formula, and you should aim for a goal of maintaining urine output of 1-1.5 Address pain with analgesia.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EMDocs

OCTOBER 7, 2023

neurologic damage and thrombosis) 20,21 Resuscitation Lactated ringers > Normal saline due to reduced need for urinary alkalinization 22 Place foley and target urine output >300 mL/hr Electrolyte abnormalities Hyperkalemia: Obtain an ECG Stabilization: Calcium gluconate 2 g over 5-10 min. BMC Pediatr. Clin Biochem.

EMS 96

EMS Fluid Resuscitation Fractures Resuscitation 96

Don't Forget the Bubbles

FEBRUARY 17, 2025

Understanding venous congestion in pediatric patients may identify new causal pathways of organ injury for critically ill patients, with potential treatment implications. For example, pediatric patients are less prone to the types of diastolic dysfunction commonly observed in adults, potentially changing the prevalence of venous congestion.

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78

Don't Forget the Bubbles

NOVEMBER 18, 2024

Before considering fluid resuscitation or inotropes, it is essential to correct the infant’s body temperature. “Practical Aspects of Blood Pressure Management in Neonatal Intensive Care Units,” Pediatric Critical Care Medicine. Hypothermia: Newborns, particularly preterm infants, are prone to hypothermia.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

EMDocs

JANUARY 20, 2025

The latest SCCM pediatric sepsis guidelines 31 recommend against a fluid bolus in children who are not hypotensive and who do not have access to intensive care, with a weak recommendation to give a 10-20 ml/kg initial bolus and up to a 40-60 ml/kg bolus in children with hypotension who do have access to critical care resources.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

EMDocs

JUNE 27, 2024

Pediatr Allergy Immunol Pulmonol. Pediatr Blood Cancer. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Pediatr Blood Cancer. C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02 mg/kg, max 0.4

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97

Taming the SRU

FEBRUARY 3, 2025

It is also worth noting that these aggressive hematologic cancers occur more commonly in children and thus the risk of TLS can be higher in the pediatric population6. mg/dl (pediatrics) calcium < 7 mg/dl Clinical Tumor Lysis Syndrome (2) - laboratory TLS + one of the following: cardiac arrhythmia seizure sudden death creatinine > 1.5x

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56

Don't Forget the Bubbles

JULY 3, 2024

In this month’s issue of Pediatrics, Brewster and colleagues investigated how well Google Translate and ChatGPT perform in translating discharge instructions. Lastly, in this month’s issue of JAMA Pediatrics, Gemmill et al. Eur J Pediatr. Pediatr Nephrol. Pediatrics. Eur J Pediatr. Pediatrics.

Pediatrics 105

Pediatrics Fluid Resuscitation Research Hospitals 105

Taming the SRU

AUGUST 25, 2023

wrist in extension clavicle tibial pediatric forearm Most likely injuries to need an x-ray? 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

Seizures 76

Seizures Fractures EKG/ECG Resuscitation 76

EMDocs

MARCH 11, 2024

Patients who cannot tolerate oral intake of fluids should receive intravenous (IV) fluid resuscitation but are encouraged to start drinking ORS as soon as they are able. Pediatr Infect Dis J. Clinicians should switch from IV hydration to ORS once hydration is improved and the patient can drink. 2013;8(1):e54395.

Dehydration 111

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 111