This post delves into the utility of orthostatic vital signs in determining volume depletion or volume loss.
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Disutility of Orthostatics in Volume Depletion
Journal Review
The VAN Assessment to Identify Large Vessel Occlusion Strokes
This review is cross-posted on REBEL EM.
Over the last three years, we have seen the rise of neurointerventional therapies for patients with ischemic strokes due to large vessel occlusions (LVOs). This group of strokes typically includes patients with occlusion of the distal intracranial carotid artery, middle cerebral artery or anterior cerebral artery.
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Core
Post-Partum Hemorrhage
This post explores post-partum hemorrhage with a focus on identification and management.
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Journal Review
SALT-ED: Balanced Solutions vs 0.9% Saline in the ED
Intravenous fluid administration is a staple of modern medical care. The advantage of crystalloid over colloid solutions is well established in the literature. However, few studies have examined differences in outcomes between “normal” saline solution (0.9% NaCl) and more “balanced” solutions such a Ringer’s Lactate or Plasma-Lyte A, which seek to more closely replicate “physiologic” conditions.
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Core
Salicylate Toxicity (Salicylism)
This post explores the presentation, diagnosis and management of salicylate toxicity.
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Post
Post-It Pearls 12.0
Teaching on a clinical shift can sometimes be difficult: it’s busy, everyone’s running around and it’s hard to capture a trainees attention. Recently, on twitter, Amal Mattu (@amalmattu) has been posting pictures of his white board teaching: discrete pearls written down and shared with anyone who walks by. The pearls are often prompted by patients presenting during that shift but they don’t have to be.
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Journal Review
ADRENAL – Corticosteroids in Septic Shock
During physiological stress, hypotension, or severe infection, the hypothalamic-pituitary-adrenal (HPA) axis is activated. The hypothalamus secretes corticotrophin-releasing hormone (CRH) stimulating the release of adrenocorticotrophin hormone (ACTH) from the anterior pituitary. This results in cortisol secretion from the adrenal glands, and as a result, serum cortisol increases.
Endogenous cortisol is thought to have many benefits in physiologic stress1.
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