Remove Fractures Remove Resuscitation Remove Shock
article thumbnail

Neurogenic Shock in Children

Pediatric EM Morsels

Physical exam findings of occult shock in children can be subtle. Fortunately, there are screening tools for occult shock. A (sorta) Quick Blurb about Spinal Shock If you, like me, have recently had to go back to review the difference between spinal and neurogenic shock , here is a quick refresher on the topic.

Shock 304
article thumbnail

Trauma Resuscitation Updates

RebelEM

I recently gave a talk on the initial management of trauma patients with hemorrhagic shock. Clinical Take Home Point: In patients with TBI and hypovolemic shock, target a SBP or MAP ≥90mmHg, but know this is based on limited evidence. vs SBP target <90mmHg which resulted in a mortality of 33.4% NEJM 1994. [2] NEJM 1994. [2]

Insiders

Sign Up for our Newsletter

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

article thumbnail

Best Of EAST 2024 #8: Whole Blood And VTE

The Trauma Pro

They cautioned against the use of TXA in the setting of whole-blood resuscitation. Specific ones that come to mind are shock, long bone or spine fractures, and TBI. Reference: Does whole blood resuscitation increase risk for venous thromboembolism in trauma patients? increase in risk. Bottom line: A lot is going on here.

article thumbnail

IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

RebelEM

13 That is to say nothing of the effect that the type and response to shock has on the individual patients involved in these studies. just be careful with pelvic fractures or any femoral arterial punctures/ devices. M-mode measurements are prone to error because of a cylindrical effect. 17 Of course, do not forget your physical exam.

article thumbnail

Don’t Forget About the IO in the Critically Ill Patient

RebelEM

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. This can often lead to significant delays in proper resuscitation. Studies reviewed landmark-based CVC compared to IO; using IJ, subclavian, and femoral CVC sites.

article thumbnail

Grand Rounds Recap 1.17.24

Taming the SRU

ETT Depth = ETT size x3 initial defibrillation: 2J/kg (next shock is 4J/kg) Toxicology Quick Hits Fomepizole is the treatment for both polyethylene glycol and methanol toxicity. Orthopedic Injuries Quick Hits Upper Extremity Injuries Galeazzi Fracture How? reduction, elbow cast, +/- ORIF Monteggia Fracture How? FOOSH What?

article thumbnail

emDOCs Podcast – Episode 103: Thermal Burn Injury

EMDocs

Most common traumatic injuries are fractures, TBIs, and thoracic or abdominal injuries. Fluid resuscitation target and fluid Fluid resuscitation is one of the most important parts of management; goal is to increase intravascular volume and ensure end organ perfusion. Always consider trauma and toxic exposure in the burn patient.

Burns 92