article thumbnail

Trauma Resuscitation Updates

RebelEM

CRYSTALLOIDS Too much crystalloid resuscitation in traumatic hemorrhagic shock can increase dilutional coagulopathy, as well as increase morbidity and mortality Bickell WH et al. I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. vs SBP target <90mmHg which resulted in a mortality of 33.4%

article thumbnail

IV Fluid Resuscitation in the Critically Ill

University of Maryland Department of Emergency Med

IV Fluid Resuscitation IVF administration is one of the most common interventions in the resuscitation of critically ill patients. Click to view the rest

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Cerebral Edema and Diabetic Ketoacidosis: Rebaked

Pediatric EM Morsels

The exact mechanism is not known… It was previously believed that it was due to rapid changes in serum osmolality during initial fluid resuscitation. Glucose > 200 mg/dL Moderate or Large Ketonuria The severity of DKA is categorized by the degree of acidosis Mild : venous pH < 7.3 Lesson = treat early!

article thumbnail

Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

RebelEM

This systematic review and meta-analysis attempts to elucidate whether a more conservative fluid resuscitation approach is warranted in volume sensitive sepsis patients, such as those with congestive heart failure (CHF). Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Am J Emerg Med. 2023;73:34-39. Am J Emerg Med.

Sepsis 118
article thumbnail

REBEL Core Cast 102.0 – Burn Management

RebelEM

Take Home Points The Parkland formula can be used to be a guide for initial fluid resuscitation. Utilize response to treatment as a guide to continue fluid resuscitation. Take Home Points The Parkland formula can be used to be a guide for initial fluid resuscitation. Read more

Burns 92
article thumbnail

Adjunctive Methylene Blue in Septic Shock?

RebelEM

Judicious fluid resuscitation is indicated in patients with signs of hypo perfusion but is often inadequate necessitating the administration of vasoactive medications. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e.

Shock 145
article thumbnail

Which Line is Sublime?

Mount Sinai EM

Standard mid-range size for trauma resuscitation is around 8Fr (the ones at Elmhurst for example are 8.5Fr) Pros : Large access with very high flow rate (lower flow rate if another catheter placed through the sheath such as a central line) to allow you to rapidly infuse fluids – often blood on our case, through them.