RebelEM

MAY 18, 2023

Background: IV fluids are part of the standard resuscitation bundle in septic shock, however it is unclear if they provide a significant benefit. The goal of the trial was to see if early vasopressors improved shock control by 6 hours. This resulted in better shock control by 6hrs (76.1% Liberal: 14.9% Liberal: 14.9%

Sepsis 105

Sepsis Shock Resuscitation Outcomes 105

Pediatric EM Morsels

MARCH 29, 2024

2000; 105:e 10. There may be an occasion when a patient is lower risk that the sub-specialist is comfortable treating as an outpatient, but realize they are not NO risk. References: Applegarth DA , Toone JR , Lowry RB. Incidence of inborn errors of metabolism in British Columbia, 1969–1996. Pediatrics. Samantha A. Schrier Vergano.

Dehydration 294

Dehydration Pediatrics Sepsis EMS 294

RebelEM

DECEMBER 17, 2024

Bottom Line Up Top: There doesnt appear to be a morbidity or mortality benefit to treating fever in sepsis and fever may have a protective effect. A large observational study of > 2000 patients found an association with fever at presentation and ICU survival for patients with severe sepsis or septic shock ( Sunden-Culberg 2017 ).

Sepsis 55

Sepsis Shock EMS Emergency Department 55

Taming the SRU

DECEMBER 17, 2024

There is substantial evidence that IV fluids can be beneficial in patients with sepsis complicated by hypotension and labor. Other contraindications include those who are unable to drink liquid (respiratory problems or impaired unconsciousness) and patients in shock, persistent vomiting, or with an ileus.

Dehydration 52

Dehydration Fluid Resuscitation Administration Resuscitation 52

PulmCCM

MAY 22, 2023

Read in NEJM Fluid resuscitation and vasopressors are both usually needed in septic shock , but the ideal volume of fluid to infuse before starting vasopressors has been unclear. centers, patients with sepsis and systolic blood pressure <100 mm Hg all received at least 1000 mL of crystalloid.

Fluid Resuscitation 86

Fluid Resuscitation Resuscitation Hospitals Sepsis 86

Sensible Medicine

AUGUST 14, 2024

In his work, Dr. Goldwater describes a kind of toxic-shock (cytokine) reaction in the body that results from the combination of a cold virus plus being infected with a common bacterium—each pathogen relatively harmless on its own but deadly together. This sort of sepsis would produce many of the common autopsy findings.

CDC 76

CDC Sepsis Research Pediatrics 76

Pediatric Emergency Playbook

NOVEMBER 1, 2015

Case 1: Sepsis Laura is a 2-month-old baby girl born at 32 weeks gestational age who today has been “breathing fast” per mother. She is in respiratory failure from bronchiolitis and likely viral sepsis. Induction Agent in Sepsis The consensus recommendation for the induction agent of choice for sepsis in children is ketamine.

Shock 40

Shock Sepsis Airway Management Pediatrics 40