Remove Resuscitation Remove Seizures Remove Shock
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But Can You Just PO?

Taming the SRU

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. Patients present to the ED with hypovolemia secondary to a plethora of causessome requiring IV fluid resuscitation and others requiring none.

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ToxCard: Iron

EMDocs

Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. 1 Obtain a single view abdominal x-ray. 2 L/hr in adults.

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emDOCs Podcast – Episode 115: Adult Meningitis

EMDocs

Neurologic deficits, seizures, cognitive issues, hearing loss. Bacterial Meningitis Mimics: Other flu-like illnesses: COVID, influenza, toxic shock syndrome, myocarditis, endocarditis, spinal epidural abscess, pneumonia. Start resuscitating with fluids, and add a vasopressor like norepinephrine. Mortality rate is 10-30%.

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2023 AHA Update on Management Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning

EMDocs

Use of 20% intravenous lipid emulsion can be efficacious in the resuscitation of life-threatening local anesthetic toxicity, especially from bupivacaine. Venoarterial extracorporeal membrane oxygenation can be lifesaving for patients with cardiogenic shock or dysrhythmias that are refractory to other treatment measure s.

Poisoning 115
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The Latest in Critical Care, 1/29/24 (Issue #27)

PulmCCM

three shocks with 2 minutes CPR in between) have been performed. EEG Advised, to Rule Out Nonconvulsive Seizures Nonconvulsive seizures are occasionally present in comatose patients after cardiac arrest, undetectable without testing. Seizure prophylaxis was advised against, as there is no evidence for its efficacy.

Seizures 115
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52 in 52 – #41: The CENSER Trial

EMDocs

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 95
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2023 AHA Update on ACLS

EMDocs

Emergent coronary angiography is not recommended over a delayed or selective strategy in patients with ROSC after cardiac arrest in the absence of ST-segment elevation, shock, electrical instability, signs of significant myocardial damage, and ongoing ischemia (Level 3: no benefit). o C recommended (Level 1: strong). COR 2a, LOE B-NR.