Remove Fluid Resuscitation Remove Ultrasounds Remove Wellness
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IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

RebelEM

Well, the established cutoff for the distensibility index is 18%. A cutoff of 18% has a positive predictive value (PPV) of 92% and NPV of 90% for fluid responsiveness. 19 These are all invaluable tools that providers can use at the bedside to assess the probability of a patient responding to IV fluids. Ultrasound Med Biol.

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Putting Clinical Gestalt to Work in the Emergency Department

ACEP Now

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.

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Tachycardia must make you doubt an ACS or STEMI diagnosis; put it all in clinical context

Dr. Smith's ECG Blog

He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. Furthermore, notice the well-formed Q-waves in inferior leads. Large volume fluid resuscitation was undertaken. The HCO3 was 8.

EKG/ECG 52
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EM@3AM: Endometritis

EMDocs

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 91
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Orofacial Infections

Mind The Bleep

Note: Painful teeth in well patients with mild, soft swellings with no palpable collection are often treatable with a course of oral antibiotics and seeking emergency dental treatment in the community via NHS111. Is there any asymmetry/fullness in the pharyngeal area? Is there tenderness of teeth to percussion/palpation?

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Preparing for your First Renal SHO On-Call

Mind The Bleep

Damaged kidneys don’t handle drugs well Or fluids! 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.

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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

EKG/ECG 40