This week we do a little spaced repetition on adrenal insufficiency and then discuss fluid responsiveness and resuscitation.
Core EM - Emergency Medicine Podcast Episode 75.0 – Fluid Responsiveness + Resuscitation
Dec 5, 2016
Explore the complexities of adrenal insufficiency and learn key management techniques that involve both volume expansion and steroid use. Discover the vital principles of fluid resuscitation and the importance of assessing fluid responsiveness, particularly in critical care settings. Delve into the risks associated with fluid management, emphasizing careful approaches to avoid the pitfalls of aggressive resuscitation strategies. This insightful discussion is packed with relevant guidelines and practical applications for improving patient outcomes.
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Listener Question on Adrenal Suppression
- A listener named Ali from the UK asked about adrenal suppression after a challenging case.
- This prompted a review on adrenal insufficiency covering congenital and acquired types and clinical features.
Understanding Fluid Responsiveness
- Fluid responsiveness means fluids increase stroke volume and cardiac output, benefiting patient perfusion.
- Giving fluids to non-responsive patients may cause harm without improving cardiac output.
Use Passive Leg Raise to Assess
- Use a passive leg raise (PLR) with real-time stroke volume assessment to test fluid responsiveness.
- PLR is reversible, non-invasive, and works even if the patient is intubated, but requires echo skill and patient repositioning ability.