School of thought has always been lower is better for stopping hemorrhage. Read the abstract here.
Ever lose an IV…of COURSE you have. Read about a recent strategy here.
5. When diuretics may not be the place to start in the ED treatment of HF
Management approaches for patients in the emergency department (ED) who present with acute heart failure (AHF) have largely focused on intravenous diuretics. Yet, the primary pathophysiologic derangement underlying AHF in many patients is not solely volume overload. Patients with hypertensive AHF (H-AHF) represent a clinical phenotype with distinct pathophysiologic mechanisms that result in elevated ventricular filling pressures. To optimize treatment response and minimize adverse events in this subgroup, we propose that clinical management be tailored to a conceptual model of disease that is based on these mechanisms. This consensus statement reviews the relevant pathophysiology, clinical characteristics, approach to therapy, and considerations for clinical trials in ED patients with H-AHF.
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Clinicians who care for children have encountered the same questions for decades: does the child have an infection, is it likely bacterial or viral, and is an antibiotic indicated? These questions were further complicated by the “discovery” of bacteremia.
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