ALiEM

JULY 22, 2023

You have a severely dehydrated patient with a peripheral IV line, requiring urgent fluid resuscitation. However, the crystalloid fluids are not flowing freely. You can not seem to find your pressure infusion cuff to squeeze the IV bag and accelerate fluid administration.

Fluid Resuscitation 96

Fluid Resuscitation Dehydration Emergency Department Administration 96

Clinical Correlations

SEPTEMBER 28, 2022

Bellevue Inpatient: What is the role of aggressive fluid resuscitation in acute pancreatitis? Bellevue Outpatient: What is the optimal duration of therapy for bisphosphates in osteoporosis? VA Inpatient: What is the treatment for allergic bronchopulmonary aspergillosis?

Fluid Resuscitation 40

Fluid Resuscitation Resuscitation 40

Mind The Bleep

DECEMBER 19, 2023

It is also vital to do a fluid balance assessment. Majority of DKA patients are in a fluid deficit and present acutely with shock. Therefore, they require fluid resuscitation to restore blood pressure, correct the ketonemia and electrolyte abnormalities, and oliguria. This is done with an initial bolus of 10ml/kg 0.9%

Dehydration 98

Dehydration Fluid Resuscitation Shock Resuscitation 98

Emergency Medicine Cases

MAY 18, 2020

Hilary Whyte, Dr. Jabeen Fayyaz, Dr. Emily MacNeill discuss a neonatal resuscitation algorithm, airway management, fluid resuscitation, central access tips, glucose and temperature control and transport tips.

Resuscitation 52

Resuscitation Fluid Resuscitation Airway Management CPR 52

The Skeptics' Guide to EM

JUNE 12, 2022

Clinical Question: Is the 90-day mortality in critically ill adult patients lower with the use of Plasma-Lyte 148, a balanced crystalloid solution, for fluid resuscitation and therapy, than with the use of normal saline? Reference: Finfer et al. Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults.

Fluid Resuscitation 52

Fluid Resuscitation Resuscitation Outcomes Administration 52

Ziqitza HealthCare Ltd

FEBRUARY 26, 2024

The paramedics are trained to provide immediate care, including cooling measures and fluid resuscitation, to mitigate the effects of extreme heat on the human body. Managing Health Crises During Extreme Weather Events Extreme weather events, whether it be a cyclone, flood, or heatwave, can lead to a surge in health crises.

Ambulance Services 52

Ambulance Services Disaster Management Fluid Resuscitation Resuscitation 52

Taming the SRU

JANUARY 12, 2024

Often AE-ILD is idiopathic, but treatable causes must be excluded (PNA, PE, volume overload) Treatment for AE-ILD should include antibiotics for CAP coverage (specifically including azithromycin), steroids, and respiratory support; consider opportunistic infection if immunosuppressed as well as diuresis as needed for euvolemia HFNC should be favored (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

Emergency Medicine Cases

JUNE 4, 2019

Nonetheless, in this podcast we’ll give you the tools to help risk stratify electrical injuries, give some guidance on fluid resuscitation, describe immediate management of acute complications and make you aware of the potential delayed complications that must be anticipated.

Fluid Resuscitation 52

Fluid Resuscitation Burns Resuscitation EMS 52

Emergency Medicine Cases

MAY 21, 2019

Things like inaccurate estimation of burn size, unnecessary endotracheal intubation, over- and under-estimation of fluid resuscitation volumes, inadequate analgesia and inappropriate wound dressings are just some of the issues where a small change to ED practice patterns could have a huge impact on patient care.

Airway Management 52

Airway Management Burns Resuscitation Fluid Resuscitation 52

Emergency Medicine Ireland

JUNE 21, 2021

Secondary causes are more likely to be related to medical illness with overly aggressive fluid resuscitation (otherwise known as iatrogenic salt water drowning) leading to oedematous abdominal structures and high pressures. If muscular tone is worsening things then get rid of it * optimise fluid resuscitation.

Fluid Resuscitation 52

Fluid Resuscitation Resuscitation Wellness 52

Don't Forget the Bubbles

NOVEMBER 27, 2023

So, fluid has been tried but has not got close to fixing the problem. In middle-to-high-income countries, after 40-60ml/kg of fluid resuscitation, the Surviving Sepsis Campaign International Guidelines recommend using vasoactive drugs. The wide pulse pressure and transient response would suggest an afterload problem.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

Northwestern EM Blog

MAY 9, 2022

Therefore, fluid resuscitation and maintenance are important. Any life-threatening hyperthermia should be treated immediately with an ice bath.[2] 2] Rigidity will lead to rhabdomyolysis with subsequent hyperkalemia and myoglobin-induced renal failure. Profound immobility can precipitate DVT, so anticoagulation may be necessary.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Psychiatric Administration 52

Mind The Bleep

APRIL 26, 2024

Investigations Bedside Observations Where there is an abscess with pus formation, the temperature will be swinging up and down Capillary blood glucose if diabetic Laboratory Venous blood gas if haemodynamically unstable Full blood count C-reactive protein Blood cultures if patient haemodynamically unstable Pus swab if discharging pus present for MC&S (..)

Emergency Department 52

Emergency Department Fluid Resuscitation Dehydration Resuscitation 52

ACEP Now

OCTOBER 3, 2023

Fluid Resuscitation Intravenous fluids should be administered in the prehospital setting to treat hypotension and/or limit hypotension to the shortest duration possible. Hypotensive patients should be treated with blood products and/or isotonic fluids in the prehospital setting.

Documentation/Coding 98

Documentation/Coding Fluid Resuscitation Resuscitation Pediatrics 98

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). CRITICAL CARE: HARD TIMES – RESUSCITATING MY PATIENT: FLUID, BLOOD AND OTHER STRATEGIES.

Sepsis 106

Sepsis Fluid Resuscitation Resuscitation Administration 106

Broome Docs

OCTOBER 31, 2022

PMID: 30206143 Less is more when it comes to intravenous fluids de-Madaria E, Buxbaum JL, Maisonneuve P, et al. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. PMID: 36103415 Bottom line: Less is more when it comes to intravenous fluids. 2018 Sep 11;362:k3843. doi: 10.1136/bmj.k3843. N Engl J Med.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Fluid Resuscitation Seizures Emergency Department 52

EMDocs

NOVEMBER 20, 2023

Hemodynamic resuscitation Key Concept: Patients with hemodynamic instability and/or suspected ongoing bleeding should receive intravenous fluid resuscitation with the goal of optimization of blood pressure and heart rate before endoscopic evaluation/intervention. (Conditional recommendation, low-quality evidence).

Resuscitation 76

Resuscitation Fluid Resuscitation Hospitals Research 76

Critical Care Now

APRIL 26, 2022

Many patients with adrenal insufficiency carry medical alerts or their own emergency medication that EMS can administer.

Resuscitation 52

Resuscitation Fluid Resuscitation EMS Sepsis 52

EMDocs

NOVEMBER 1, 2023

6 Treatment : Airway Definitive airway management should be performed in those with respiratory distress with attention to appropriate resuscitation started beforehand in the setting of potential distributive shock from mediastinitis. 4 Fluid resuscitation and vasopressor use as appropriate.

Operations 64

Operations Radiology Radiology Fluid Resuscitation 64

ACEP Now

MARCH 14, 2024

Treatment for burns should focus on fluid resuscitation as appropriate based on your institution’s burn protocol per Brooke, Parkland, Rule of 10s etc. Lastly, vessels can be damaged by internal burns, which may lead to poor perfusion and delayed complications as thrombosis or third spacing.

Burns 52

Burns Fluid Resuscitation EKG/ECG Operations 52

Emergency Medicine Ireland

APRIL 4, 2022

It doesn’t take them long to transition to the more conventional ICU patient where fluid does nothing but increase the oedema but in the first 6-12 hours fluid resuscitation often has a role. Likely driven by rewarming induced vasodilation and hypothermia induced diuresis they can be hypovolaemic.

Fluid Resuscitation 40

Fluid Resuscitation Hyperthermia / Hypothermia Outcomes Resuscitation 40

The Skeptics' Guide to EM

JUNE 15, 2018

It is like normal saline vs. Ringer’s lactate for fluid resuscitation, steroids vs. no steroids for sepsis, or Coke vs. Pepsi. Background: Atrial fibrillation, rate control vs. rhythm control. This is a debate that has gone on for many years.

Emergency Department 52

Emergency Department Fluid Resuscitation Hospitals Sepsis 52

Mind The Bleep

MAY 12, 2023

9 There is no role for Tranexamic acid in upper GI bleeding and its use is harmful to patients 11 Escalate to a senior early for consideration of a higher level of care Refer for early endoscopy after resuscitation with haemodynamic stability. On Day 3 (i.e. 48 hours later) albumin is administered at 1g/kg. On Day 3 (i.e.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

ACEP Now

NOVEMBER 16, 2023

Fluid resuscitation should be initiated. Patients should be assessed for evidence of hypovolemia or active exsanguination. Whatever the underlying cause, the patient should have two large-bore intravenous (IV) lines placed and be put on pulse oximetry and cardiac monitoring.

Best Practices 52

Best Practices Resuscitation Fluid Resuscitation Outcomes 52

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9%

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

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

RebelEM

MAY 25, 2023

In the initial management of trauma patients there are 4 key principles that should be followed: Control bleeding Restore tissue perfusion Minimize iatrogenic injury from the resuscitation itself Promote hemostasis References: Dutton RP et al. Hypotensive resuscitation during active hemorrhage: impact on in-hospital mortality.

Resuscitation 145

Resuscitation Fluid Resuscitation Head Injuries Shock 145

Mind The Bleep

FEBRUARY 27, 2024

There could be any number of reasons for this but some examples are: they have severe D&V and aren’t keeping fluids down, or because they are pre or post-op, or have presented very unwell and need fluid resuscitation. saline + 5% dextrose or plasma-lyte 148 + 5% dextrose.

Fluid Resuscitation 96

Fluid Resuscitation Hospitals Dehydration Research 96

The Skeptics' Guide to EM

FEBRUARY 17, 2018

Intervention: Ceftriaxone 2g IV * Control: Usual care (fluid resuscitation and supplementary oxygen) * Outcome: * Primary: All-cause mortality at 28 days

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

Don't Forget the Bubbles

MARCH 18, 2024

She receives fluid resuscitation, and you organise some tests to find out why she is so tired. 4-year-old Stephanie presents with vomiting, diarrhoea, and lethargy. She appears pale and dehydrated , and her level of alertness fluctuates. She is apyrexial, tachycardic and normotensive. What causes haematuria in children?

Dehydration 59

Dehydration Infectious Diseases Seizures Pediatrics 59

ACEP Now

FEBRUARY 11, 2024

Management of symptoms is the same for all of these, relying upon fluid resuscitation, antiemetics, and electrolyte repletion.

Seizures 52

Seizures Fluid Resuscitation Poisoning EKG/ECG 52

Mind The Bleep

FEBRUARY 9, 2024

Take your time, and list in chronological order what interventions you have tried, and any evidence of response, for example; MAP (as this is a better indicator of perfusion than systolic BP) before and after fluid resuscitation (NICE suggests 2000ml of IV fluids as the cutoff for involving senior support, the Society of Critical Care Medicine suggest (..)

Hospitals 52

Hospitals Resuscitation Fluid Resuscitation Shock 52

RebelEM

SEPTEMBER 29, 2022

There are also potential harms to large volume fluid resuscitation including progression of pancreatitis and fluid overload with or without respiratory failure. Though the initial recommendation for aggressive fluid resuscitation was not based on substantial evidence, clinicians have been slow to pivot away from this approach.

Administration 52

Administration Fluid Resuscitation Resuscitation Outcomes 52

EMDocs

JULY 17, 2023

Measures to optimize the patient for surgical intervention and treat shock, including antibiotics and fluid resuscitation, are associated with improved outcomes in these patients. Bowel perforation demonstrated by CT, hard signs of peritonitis, or an overall toxic appearance warrant emergent surgical consultation.

Operations 73

Operations EMS Fluid Resuscitation Shock 73

Dr. Smith's ECG Blog

OCTOBER 26, 2010

Large volume fluid resuscitation was undertaken. Even after 3 liters of fluid, his CVP was very low. In this case, bedside echo did not reveal a no wall motion abnormality, but there was hyperdynamic function, which is not consistent with cardiogenic shock but rather with sepsis or volume deficit. The K returned at 6.9

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

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.

Shock 52

Shock Resuscitation Outcomes Fluid Resuscitation 52

RebelEM

MAY 29, 2023

Judicious fluid resuscitation is indicated in patients with signs of hypo perfusion but is often inadequate necessitating the administration of vasoactive medications. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e.

Shock 142

Shock Fluid Resuscitation Sepsis Resuscitation 142