Northwestern EM Blog

FEBRUARY 14, 2022

This data shows us that angiotensin II can make the blood pressure better but I would never let it distract you from the things we know matter in sepsis resuscitation. In my personal practice, I make sure to optimize these and start vasopressin shortly after the initiation of norepinephrine.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 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.)

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75

Mind The Bleep

DECEMBER 31, 2023

For IV fluid requirements, be gentle and cautious, especially in dialysis patients. Again, ask your registrar or consultant if you are unsure about fluid resuscitation/balance/maintenance in renal patients. Too much fluid may have been taken off in dialysis. Always run renal drug dosing by a pharmacist if you are unsure.

Fluid Resuscitation 52

Fluid Resuscitation Hospitals Sepsis EKG/ECG 52

EB Medicine

OCTOBER 1, 2018

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. One, lung ultrasound can be really useful to find that occult pneumonia or differentiating pneumonia from CHF.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

DECEMBER 18, 2023

13,14 Fluids Fluid resuscitation is a mainstay of sepsis therapy, as the condition is commonly associated with both absolute and relative hypovolemia. 15 Two changes were elucidated in the 2021 SSC guidelines for fluid resuscitation. Additionally, the recommendation to use a 30 cc/kg bolus was downgraded.

Sepsis 72

Sepsis Fluid Resuscitation Resuscitation Shock 72

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.

EMS 82

EMS Fluid Resuscitation Fractures Resuscitation 82

EMDocs

JULY 17, 2023

3 Point of care ultrasound (POCUS) can be highly sensitive for free fluid and pneumoperitoneum when used by a trained physician in the appropriate patient population. However, a negative plain radiograph should not be used to rule out obstruction and cannot usually determine the etiology of colonic dilatation.

Operations 86

Operations EMS Fluid Resuscitation Resuscitation 86

EMDocs

JULY 13, 2024

Evaluate for retained products of conception as etiology Diagnosis Diagnosis of endometritis with at least two of the following: 8 Fever >100.4F

OB/GYN 70

OB/GYN EMS Sepsis Fluid Resuscitation 70

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

Thinking Critical Care

AUGUST 3, 2024

This exclusive event, produced in collaboration with Flosonics Medical, will take place on September 28th, 2024 , in Toronto , Ontario, Canada This masterclass is designed for those who seek a deep dive into the cutting-edge techniques of venous congestion, Doppler ultrasound, and fluid resuscitation.

Fluid Resuscitation 52

Fluid Resuscitation Documentation/Coding Resuscitation Ultrasounds 52

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 Let’s move on to treatment.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Intensive Blog

FEBRUARY 9, 2023

Other investigations to consider include imaging of the liver with ultrasound and computerised tomography (CT) to assess for any changes to the liver parenchyma or vasculature, such as portal vein thrombosis or Budd Chiari Syndrome (hepatic venous outflow obstruction).

Poisoning 52

Poisoning Hyperthermia / Hypothermia Fluid Resuscitation Resuscitation 52

Taming the SRU

MAY 5, 2023

It would be interesting to stratify the doses of vasopressor administration to the few potential adverse events (all of which resolved), or the location of the peripheral line, given the questions raised regarding safety and patency of ultrasound-guided IVs versus non-ultrasound guided-IVs. Front Med (Lausanne) 8 : 628302. Kuttab, H.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

EMDocs

JANUARY 20, 2024

Bedside ultrasound shows hypokinesis of the basal portion of the left ventricle with an apparent sigmoid-shaped septum and a dilated inferior vena cava. Ultrasound findings can show bulging of the interventricular septum into the LVOT , which can be interpreted as a sigmoid-shaped septum on bedside evaluation. The oral mucosa is moist.

EMS 82

EMS Fluid Resuscitation Shock EKG/ECG 82

EMDocs

JANUARY 20, 2025

Over the last few years, however, ultrasound has been increasingly playing an important role in the conversation with multiple studies looking at using ultrasound to predict fluid responsiveness in septic patients – for example, using the velocity time integral with passive leg raise. Tullo et al. Tullo et al. Keijzers, G.,

Dehydration 67

Dehydration Fluid Resuscitation Sepsis Resuscitation 67

Don't Forget the Bubbles

FEBRUARY 17, 2025

He has had some additional episodes of hypotension post-intubation, which is treated with further volume resuscitation. Before considering a further fluid bolus, you do a point-of-care ultrasound (POCUS). J Ultrasound Med, 2023. Aiming for zero fluid accumulation: First, do no harm. References 1. Prager, R.,

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78