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 84

Dehydration Fluid Resuscitation Administration Resuscitation 84

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 104

Sepsis Shock Resuscitation Outcomes 104

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 297

Dehydration Pediatrics Sepsis EMS 297

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

Taming the SRU

AUGUST 30, 2023

Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear. A 2013 meta-analysis of 30 studies including 3,244 patients published in The Lancet found PCT to have a pooled sensitivity of 77% and specificity of 79% for sepsis in critically ill patients [52]. Cleland DA, Eranki AP.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Don't Forget the Bubbles

NOVEMBER 15, 2023

Jasmine, a hypothetical case Jasmine is a 5-year-old girl weighing 18kg admitted to PICU with suspected sepsis. She had septic shock on presentation and was resuscitated with 60ml/kg of balanced crystalloid solution and escalating vasoactive medications. Remember, we can add more if needed, but taking it away is much harder.

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

RebelEM

MARCH 27, 2023

4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. 2000 May 4; PMID: 10793162 Harvey CE, et al. Patients at risk for ARDS were stratified by the Lung Injury Prevention Score (LIPS) which predicts the probability of developing ARDS and subsequent mortality.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52