Taming the SRU

JANUARY 12, 2024

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 (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

Dr. Smith's ECG Blog

OCTOBER 26, 2010

ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. Then ACS (STEMI) might be primary; this might be cardiogenic shock. Large volume fluid resuscitation was undertaken. Even after 3 liters of fluid, his CVP was very low. Are the lungs clear? Is the patient cool and pale? Cr was 13.4.

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

PulmCCM

MAY 22, 2023

Read in NEJM Fluid resuscitation and vasopressors are both usually needed in septic shock , but the ideal volume of fluid to infuse before starting vasopressors has been unclear. centers, patients with sepsis and systolic blood pressure <100 mm Hg all received at least 1000 mL of crystalloid.

Fluid Resuscitation 86

Fluid Resuscitation Resuscitation Hospitals Sepsis 86

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.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Don't Forget the Bubbles

NOVEMBER 18, 2024

Sepsis: This can induce widespread vasodilation and capillary leak, exacerbating hypotension. Blood Tests: Can help identify underlying causes such as infection (sepsis), anaemia, or electrolyte imbalances. Before considering fluid resuscitation or inotropes, it is essential to correct the infant’s body temperature.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

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. were more likely to respond.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

EMDocs

NOVEMBER 1, 2023

1 , 4 If presenting later in course or with an intra-abdominal perforation, patients are more likely to show signs of sepsis and hemodynamic instability. VBG with lactate 4 – may show low pH with elevated lactate Cardiac biomarkers – to evaluate for cardiac etiology in those presenting with chest pain or type II NSTEMI in those with sepsis.

Operations 68

Operations Radiology Radiology Fluid Resuscitation 68

Critical Care Now

APRIL 26, 2022

A reduced supply of cortisol will decrease vascular tone, causing systemic vasodilation, shock, and hemodynamic collapse. Many patients with adrenal insufficiency carry medical alerts or their own emergency medication that EMS can administer.

Resuscitation 52

Resuscitation Fluid Resuscitation EMS Sepsis 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

In addition, the patient received 750 mL of fluid resuscitation with transient improvement of blood pressure. Authors' commentary: Cardiogenic shock in the setting of severe aortic stenosis. Fundamentally, cardiogenic shock is an issue of decreased cardiac output. If you can use Doppler, then you can diagnose it.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

EMDocs

JUNE 27, 2024

-smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02 mg/kg, max 0.4 C or 100.4

Pediatrics 76

Pediatrics EMS Dehydration Hospitals 76

Mind The Bleep

FEBRUARY 9, 2024

48 hours) to help her through the initial period of sepsis while her antibiotics take time to work. Circulation Is there evidence of shock – think hypoperfusion; confusion, chest pain, rising lactate, low BP.What is the most likely cause of this? Breathing Is there evidence of respiratory failure?If Is it reversible?

Hospitals 52

Hospitals Resuscitation Fluid Resuscitation Shock 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. older than 65 years; b.]

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

EB Medicine

NOVEMBER 1, 2018

Jeff: And unlike past issues covering more common pathologies, like, say, sepsis, this month’s team reviewed much more literature than just the past 10 years. Nachi: Each year, in the US, approximately 10,000 patients present with electrical burns or shocks. In total, they pulled references from 1966 until 2018. That’s -- high.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 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. vs. 0.91), positive predictive value (0.27

Sepsis 66

Sepsis Fluid Resuscitation Resuscitation Shock 66

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 Hospitals Dehydration Research 96

EMDocs

OCTOBER 5, 2024

8 Workup and Diagnosis Evaluation should be tailored to the patient presentation, but may include studies such as: CBC, CMP, UA, lactate (if concern for sepsis), Cultures (blood, urine, etc.) IV fluid resuscitation as needed. Pressors where indicated for septic shock (typically Norepinephrine starting at 0.05

EMS 75

EMS Infectious Diseases Sepsis Hospitals 75

Don't Forget the Bubbles

JULY 3, 2024

Trends in C-Reactive Protein Use in Early-Onset Sepsis Evaluations and Associated Antibiotic Use. Fluid resuscitation in children with severe infection and septic shock: a systematic review and meta-analysis. Pediatrics. 2024 Jun 18:e2023065373. Accuracy of Urinalysis for UTI in Spina Bifida. Forster CS, et al.

Pediatrics 105

Pediatrics Fluid Resuscitation Research Hospitals 105

The Skeptics' Guide to EM

JUNE 15, 2018

Usually they just shock me and send me home.” It is like normal saline vs. Ringer’s lactate for fluid resuscitation, steroids vs. no steroids for sepsis, or Coke vs. Pepsi. I’ve had atrial fibrillation a number of time before. Background: Atrial fibrillation, rate control vs. rhythm control.

Emergency Department 52

Emergency Department Fluid Resuscitation Hospitals Sepsis 52