Remove ICU Remove OR Remove Plasma
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SGEM#368: Just A Normal Saline Day in the ICU – The PLUS Study

The Skeptics' Guide to EM

He is board certified […] The post SGEM#368: Just A Normal Saline Day in the ICU – The PLUS Study first appeared on The Skeptics Guide to Emergency Medicine. sodium chloride), and balanced crystalloid solutions, meaning those with a chloride composition closer to plasma such as lactated ringer’s or Plasma Lyte 148.

ICU 132
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SGEM#347: It Don’t Matter to Me – Balanced Solution or Saline

The Skeptics' Guide to EM

Clinical Question: Does administration of a balanced solution (Plasma-Lyte 148) during intensive care unit (ICU) stay, compared with saline solution, result in improved 90-day survival in critically ill patients? Date: September 28th, 2021 Reference: Zampieri et al. Effect of Intravenous Fluid Treatment With a Balanced Solution vs 0.9%

OR 130
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Transfusion Reactions

Core EM

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

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Handed this ECG from triage. What will you do?

Dr. Smith's ECG Blog

The patient stabilized and was transferred for ICU admission. Don't forget beta agonists in the treatment of hyperkalemia: Terbutaline and Albuterol for Lowering of Plasma Postassium (includes many abstracts) The below abstracts show that beta 2 adrenergic agonists are effective at treating hyperkalemia. mg) lowers it by about 1.0

Plasma 113
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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

REBEL EM

Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72 NOT STATISTICALLY SIGNIFICANT Also no difference in individual components given Thromboembolic Events: 4F-PCC: 35% Placebo: 24% Absolute Diff: 11%; 95% CI 1 to 21% Relative Risk 1.48; 95% CI 1.04 to 2.10; P = 0.03 Severe acute traumatic coagulopathy = PT >1.5 to 3.33; P = 0.72

FFP 145
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Episode 23: COVID-19 pneumonia with Nicole King

Critical Care Scenarios

Treat initially with steroids per the RECOVERY trial (dexamethasone 6 mg daily for 10 days); then, if needing ICU or especially if needing intubation, consider the DEXA-ARDS protocol (20 mg daily for 5 days, then 10 mg daily for another 5 days). Prone early, when the lungs are still recruitable and salvageable. .*

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Episode 39: ECMO for COVID-19 with Kim Boswell

Critical Care Scenarios

Plasma free hemoglobin levels may be a useful marker that changing your oxygenator could improve gas exchange.* Decannulate at the bedside when ready, watch them for 24 hours, then boot them out of the ICU; they’re ready.* Anticoagulate most patients on VV ECMO with heparin to a PTT of 45-55. Data remains slim,