Remove Fluid Resuscitation Remove Seizures Remove Wellness
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EM@3AM: Amniotic Fluid Embolism

EMDocs

The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. Eclampsia (B) is characterized by the onset of seizures in a woman with preeclampsia (hypertension and proteinuria), but it typically does not present with the sudden onset of respiratory distress and profound hypotension described here.

EMS 96
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Chemical Burns

Mind The Bleep

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
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Grand Rounds Recap 1.10.24

Taming the SRU

Often AE-ILD is idiopathic, but treatable causes must be excluded (PNA, PE, volume overload) Treatment for AE-ILD should include antibiotics for CAP coverage (specifically including azithromycin), steroids, and respiratory support; consider opportunistic infection if immunosuppressed as well as diuresis as needed for euvolemia HFNC should be favored (..)

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Grand Rounds Recap 8.9.23

Taming the SRU

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

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Popular Antiobesity Medications Bring New Challenges to Emergency Physicians

ACEP Now

Patient C, a 27-year-old female with a history of epilepsy, taking valproate and endorsing adherence, is then brought in by ambulance for a witnessed seizure. This is her first seizure in six years. Management of symptoms is the same for all of these, relying upon fluid resuscitation, antiemetics, and electrolyte repletion.

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Brain Trauma Guidelines for Emergency Medicine

ACEP Now

Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. Hypotensive patients should be treated with blood products and/or isotonic fluids in the prehospital setting.

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emDOCs Revamp: Esophageal Perforation

EMDocs

1 , 2 The most common non-iatrogenic cause is spontaneously due to increased intraesophageal pressure, Boerhaave syndrome, from forceful retching, coughing, straining, seizures, or even childbirth (15% of cases). Caution with use of NIPPV – positive pressure can worsen injury as well as increase subcutaneous emphysema.