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Study Investigates The Role Of Fluid Resuscitation In Treatment Of Life-Threatening Infections

Dehydration is a common phenomenon in those suffering from infectious diseases, particularly if the diseases cause vomiting and/or diarrhea. We are all familiar with having the “stomach flu,” “traveler’s diarrhea,” or food poisoning. However, severe infections of all sorts can cause profound illness, debilitation, and fluid losses. In many developing countries, very large numbers of small children are afflicted with non-gastrointestinal infectious diseases that rapidly cause relatively large fluid losses, and therefore profound, life-threatening dehydration, which is manifested in part by dangerously low blood pressure and subsequent failure to deliver precious liquid, nutrients and oxygen to the tissues of the body. This is called “shock.”

The following discussion is cutting edge information, but not simplistic or necessarily easy to understand or apply. However, I have learned that my readers are often volunteers in settings where intensive care medicine must be applied, and want to read more than simple approaches to therapy. So, I am going to do my best to interpret for you what has recently been published in the New England Journal of Medicine in an article entitled “Mortality after Fluid Bolus in African Children with Severe Infection” (N Engl J Med 2011; 364:2483-95) written by Kathryn Maitland and her colleagues.

The focus of their investigation was Read more »

This post, Study Investigates The Role Of Fluid Resuscitation In Treatment Of Life-Threatening Infections, was originally published on Healthine.com by Paul Auerbach, M.D..

Complications Associated With The Rescue Of Injured Persons In Isolated Environments

Mountains by the ocean in Antarctica.Isolated environments combined with austere circumstances sometimes call for extraordinary measures, and in particular call for planning in advance for situations of multi-casualty incidents. Many, if not most, austere settings are in outdoor or frankly wilderness settings. Anyone who spends considerable time in the outdoors is going to sooner or later encounter a group of individuals in need of assistance in a setting of limited resources. This could be a scout troop suffering sunburn, multiple persons stung by a swarm of bees, a group of people struck by lightning, or a carful of people in a vehicle swamped and trapped in a flood. A winter camping expedition might be overcome by an unanticipated storm that generates victims of hypothermia. At the ends of the earth, the risks may be greater and multiplied by the very difficult logistics of rescue and evacuation.

Christopher Mills, MD and colleagues recently published a very interesting article entitled “Mass Casualty Incident Response and Aeromedical Evacuation in Antarctica” (Western Journal of Medicine 2011;12(1):37-42). This excellent review addresses the complications of multiple environmental and operational challenges, and highlights that Read more »

This post, Complications Associated With The Rescue Of Injured Persons In Isolated Environments, was originally published on Healthine.com by Paul Auerbach, M.D..

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