RebelEM

DECEMBER 27, 2023

Norepinephrine is a great first line vasopressor in Cardiogenic shock. Dobutamine is useful for inotropic support in Cardiogenic shock. Norepinephrine is a great first line vasopressor in Cardiogenic shock. Dobutamine is useful for inotropic support in Cardiogenic shock. Use POCUS in ED. Read more

Shock 110

Shock EMS Resuscitation 110

Dr. Smith's ECG Blog

JULY 25, 2024

For clarity in Figure-1 — I've reproduced today's ECG — obtained following successful resuscitation of out-of-hospital cardiac arrest. == MY Comment , by K EN G RAUER, MD ( 7/5 /2024 ): == Clinical ECG interpretation is a 2-Step process. Figure-1: The initial ECG in today's case. —

Resuscitation 116

Resuscitation EKG/ECG CPR Shock 116

PulmCCM

OCTOBER 14, 2024

Albumin has thus been a physiologically attractive therapy as a resuscitation fluid for hypotensive critically ill patients. How well does it work?

Resuscitation 52

Resuscitation Shock Wellness 52

The Trauma Pro

JUNE 18, 2024

Early resuscitation, particularly with blood products in patients with hemorrhage, is literally a lifesaver. To facilitate this, massive transfusion protocols (MTP) have been designed to rapidly deliver sizable quantities of blood products to the trauma resuscitation bay. As each minute ticks by, survival slowly diminishes.

Pediatrics 113

Pediatrics Blood Transfusions Resuscitation Shock 113

EM Ottawa

APRIL 18, 2024

Resuscitation with blood products in patients with trauma-related hemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomized, controlled, phase 3 trial Background The use […] The post PTM Journal Club: Blood Product and ACE-CPR use Prehospital appeared first on EMOttawa Blog.

CPR 111

CPR Resuscitation Shock Wellness 111

Mount Sinai EM

OCTOBER 2, 2023

Standard mid-range size for trauma resuscitation is around 8Fr (the ones at Elmhurst for example are 8.5Fr) Pros : Large access with very high flow rate (lower flow rate if another catheter placed through the sheath such as a central line) to allow you to rapidly infuse fluids – often blood on our case, through them.

Resuscitation 231

Resuscitation Fluid Resuscitation Administration Shock 231

PHARM

APRIL 28, 2023

Some joker on Twitter called Chrimes took this at Aspen, Colorado It is an oft quoted maxim of trauma resuscitation that shock is haemorrhagic until proven otherwise. Cardiac causes of shock in trauma? Albeit yes he/she may be in shock due to a smashed femur but what of their cardiogenic shock from the acute anterior MI?

Shock 52

Shock Resuscitation Wellness 52

RebelEM

NOVEMBER 30, 2023

This systematic review and meta-analysis attempts to elucidate whether a more conservative fluid resuscitation approach is warranted in volume sensitive sepsis patients, such as those with congestive heart failure (CHF). Am J Emerg Med. 2023;73:34-39. What They Did: Researchers performed a systematic review and meta-analysis.

Sepsis 121

Sepsis Fluid Resuscitation Resuscitation Administration 121

Taming the SRU

MARCH 30, 2023

Diastolic shock index and clinical outcomes in patients with septic shock. O: There was an association between increased diastolic shock index score and mortality at 90 days and performed similarly to more advanced measures of morbidity and mortality in septic shock including lactate levels and SOFA scores.

Shock 52

Shock Outcomes Sepsis Resuscitation 52

Dr. Smith's ECG Blog

MAY 26, 2023

A 20-something presented after a huge verapamil overdose in cardiogenic shock. He was admitted to the ICU and was unstable, in shock, overnight. This was a very complex case and the details are too much for an ECG Blog, but suffice it to say that, s hortly thereafter, the patient had an asystolic arrest and was resuscitated.

Shock 89

Shock EKG/ECG Documentation/Coding Resuscitation 89

Emergency Medicine Journal

SEPTEMBER 25, 2024

The initial ED assessment, resuscitation and critical care of the severely burned patient present significant challenges and require a multidisciplinary approach. The management of these patients in the resuscitation room impacts on the effectiveness of continuing care in the intensive care unit. require specialist burn care.

Burns 98

Burns Fluid Resuscitation Airway Management Resuscitation 98

ACEP Now

JULY 7, 2023

However, between four and five percent of cases of VT or VF will be refractory to standard management, with nonperfusing arrhythmia persisting despite repeated shocks. Initial guidelines defined “refractory” as VT or VF occurring despite three shocks from a cardiac defibrillator. Resuscitation. Resuscitation. Circulation.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

Emergency Medicine Journal

OCTOBER 26, 2023

Inclusion criteria were non-traumatic cardiac arrests treated with at least one external electric shock with an automated external defibrillator from the basic life support team and resuscitated by a physician-staffed ALS team. Primary outcome was survival at hospital discharge with a good neurological outcome.

Resuscitation 75

Resuscitation Basic Life Support Hospitals CPR 75

Emergency Medicine Cases

SEPTEMBER 12, 2023

The post EM Quick Hits 51 – Methylene Blue in Septic Shock, TMJ Dislocation, Crohn’s Disease, Analgesia for Renal Colic, Inhaled Steroids for Asthma, Hypocalcemia in Bleeding Trauma Patients appeared first on Emergency Medicine Cases.

Dislocations 89

Dislocations Shock EMS Sepsis 89

Emergency Medicine Cases

JANUARY 14, 2020

In this CritCases blog, Shock and Hypoxia in Blunt Chest Trauma, a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, Mike Misch guides us through a hairy thoracic trauma case, reviewing principles of trauma resuscitation, airway considerations, tension pneumothorax management and a rare and challenging trauma diagnosis.

Shock 52

Shock Ambulance Services Resuscitation EMS 52

ED ECMO

JANUARY 1, 2021

In this episode Joe Bellezzo talks with Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) expert Dr. Zaf Qasim about NON-TRAUMA applications of aortic compression for control of non-compressible non-trauma torso hemorrhage. We discuss this case which highlights the benefit of REBOA as a bridge to definitive hemorrhage control.

Shock 52

Shock Resuscitation Radiology Radiology 52

The Trauma Pro

AUGUST 6, 2024

Early availability of blood is a key component in the successful resuscitation of severely injured trauma patients. The resuscitation continues. The two most common ones are the ABC score and the Shock Index. Critically injured patients result in an intense and highly charged trauma activation. “Hang another unit.”

Resuscitation 113

Resuscitation Shock 113

RebelEM

MAY 18, 2023

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. The goal of the trial was to see if early vasopressors improved shock control by 6 hours. This resulted in better shock control by 6hrs (76.1% Liberal: 14.9% Liberal: 14.9%

Sepsis 105

Sepsis Shock Resuscitation Outcomes 105

Dr. Smith's ECG Blog

JULY 9, 2024

He underwent resuscitation including vasopressors, inotropic support, and intubation. Despite anticipation by many that the initial post-resuscitation ECG will show an obvious acute infarction — this expected "STEMI picture" is often not seen. The Post-Resuscitation ECG: I thought the initial ECG in today's case was not obvious.

EKG/ECG 107

EKG/ECG Resuscitation Shock CPR 107

EM Literature of Note

JANUARY 27, 2024

A brief post collating a few bits of my various work published across the interwebs … The Annals of Emergency Medicine Podcast continues to summarise the meatiest articles from each month, featuring a cycle of new co-hosts, as well: Apple Podcasts Google Podcasts Soundcloud Naturally, there are continuing Journal Club features, covering the (..)

Resuscitation 94

Resuscitation Emergency Department Shock Wellness 94

Taming the SRU

DECEMBER 17, 2024

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.

Dehydration 82

Dehydration Fluid Resuscitation Administration Resuscitation 82

RebelEM

APRIL 29, 2024

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.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Emergency Medicine Cases

JANUARY 4, 2022

What is the preferred order of vasopressors and ionotropes in the management of cardiogenic shock? How can we best pick up occult cardiogenic shock before it floured shock kicks in? What is the evidence for intra-aortic balloon pumps, percutaneous ventricular assist devices and ECMO in the patient with cardiogenic shock?

Shock 52

Shock Operations Ultrasounds Resuscitation 52

PulmCCM

DECEMBER 11, 2023

Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid bolus) led to similar outcomes as the usual practice of bolusing large volumes of fluids first. Either approach in severe sepsis with shock seems reasonable.

Sepsis 94

Sepsis Stroke Shock Infectious Diseases 94

Emergency Medicine Cases

MARCH 26, 2019

Sara Gray, intensivist and emergency physician, co-author of The CAEP Sepsis Guidelines, answers questions such as: How does one best recognize occult septic shock? Which fluid and how much fluid is best for resuscitation of the septic shock patients? What are the indications for a second vasopressor after norepinephrine?

Sepsis 40

Sepsis Shock EMS Resuscitation 40

Greater Sydney Area HEMS

FEBRUARY 20, 2024

Obtaining access in shocked trauma patients can be notoriously difficult due to circulatory collapse. Those who are shocked, shut down with limited or no other options for peripheral access require central access. Right Brachiocephalic Vein Origin Access for the Resuscitation of Shocked Adult Trauma Patients. Green et al.

Ultrasounds 98

Ultrasounds Shock Research Operations 98

PulmCCM

NOVEMBER 1, 2024

Neither of two large randomized trials in the 2000s showed a benefit from albumin solutions as a resuscitation fluid for patients with septic shock. Significant uncertainty remained, though, as we discussed further here: Another randomized trial was therefore performed, dubbed ABC-SEPSIS.

Sepsis 40

Sepsis Shock Resuscitation 40

RebelEM

FEBRUARY 8, 2024

Background: Patients with shock frequently present with hypotension. were they in the resuscitative phase? Many of these patients are started on vasopressor and inopressor medications to assist in efforts to normalize blood pressure to help improve organ perfusion. to 1.12; p = 0.03 to 0.99; p <0.01 to 1.09; p = 0.01

Resuscitation 126

Resuscitation Outcomes EMS Sepsis 126

Don't Forget the Bubbles

OCTOBER 7, 2024

Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)? Children, especially toddlers, may insert objects into outlets, leading to shocks or burns. Electrical devices used near water sources can cause severe shocks. Was the voltage high or low (as below)?

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

Pediatric Emergency Playbook

JUNE 1, 2016

Do we recognize shock early enough? World wide, shock is a leading cause of morbidity and mortality in children, mostly for failure to recognize or to treat adequately. So, what is shock? Simply put, shock is the inadequate delivery of oxygen to your tissues. How do we prioritize our interventions? Pericardial Effusion?

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

University of Maryland Department of Emergency Med

DECEMBER 8, 2022

This paper outlines a training course by Hartford Hospital for general surgery and emergency medicine residents. Their goal was to assess pre-a. Click to view the rest

Resuscitation 40

Resuscitation Shock Hospitals 40

Advanced Emergency Nursing from AENJ

MAY 3, 2014

Although told several times, the story of the development by Henning Ruben of the prototypical modern manual resuscitator, the self-refilling bag with unidirectional non-rebreathing valves which now dominate the world of resuscitation, is still not well-known. Czech Military resuscitation kit, 1969, mfr.

Resuscitation 40

Resuscitation Military Operations Emergency Nursing 40

EMDocs

AUGUST 17, 2023

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 68

Sepsis Shock Resuscitation Fluid Resuscitation 68

Emergency Medicine Cases

APRIL 23, 2024

In this month's EM Quick Hits podcast: Justin Morgenstern on the first RCT of high dose nitroglycerin in SCAPE, Andrew Neill on Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) indications and evidence, Brit Long on indications for CT in suspected diverticulitis, Tahara Bhate on Central Retinal Artery Occlusion (CRAO) and diagnostic (..)

EMS 111

EMS Resuscitation Outcomes Allergic Reactions 111

EMDocs

SEPTEMBER 6, 2023

Resuscitate and administer antibiotics. Differential Diagnosis for patient: Infectious endocarditis, CNS infection or abscess, necrotizing soft tissue infection, toxic shock, obstructive pyelonephritis, toxic ingestion, TTP, anaphylaxis with primarily hemodynamic effects, thromembolic phenomenon. Complete primary and secondary survey.

Anaphylaxis 71

Anaphylaxis Shock Sepsis Stroke 71

EB Medicine

NOVEMBER 17, 2020

Write us at emplify@ebmedicine.net. Write us at emplify@ebmedicine.net.

Emergency Department 40

Emergency Department Shock Resuscitation CPR 40

Emergency Medicine Cases

AUGUST 24, 2021

What is the utility of the Shock Index in older patients? The post Ep 159 Geriatric Trauma Part 1: The Under-Triaging Problem, Resuscitation, Airway, Head and C-spine Imaging, Clearing the C-spine appeared first on Emergency Medicine Cases. How should we adjust airway management for the older trauma patient? and many more.

Resuscitation 52

Resuscitation Head Injuries Airway Management Shock 52