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. A safer version of the pertussis vaccine was introduced in 1996.

CDC 100

CDC Sepsis Research Pediatrics 100

Pediatric Emergency Playbook

NOVEMBER 1, 2015

Etomidate is perfectly acceptable, but ketamine is actually a superior drug to etomidate in the rapid sequence intubation of children in septic shock. in Anethesia and Analgesia in 2000. On the other side of the spectrum, permissive hypotension is not described in children, as hypotension is a late and dangerous sign of shock.

Shock 40

Shock Sepsis Airway Management Pediatrics 40

Mind The Bleep

DECEMBER 16, 2023

It is the most commonly imported tropical disease in the UK, and is a medical emergency.

Rapid Diagnostic Testing 52

Rapid Diagnostic Testing Infectious Diseases Best Practices Seizures 52

Don't Forget the Bubbles

NOVEMBER 15, 2023

She had septic shock on presentation and was resuscitated with 60ml/kg of balanced crystalloid solution and escalating vasoactive medications. Park, The role of albumin in critical illness, BJA: British Journal of Anaesthesia , Volume 85, Issue 4, 1 October 2000, Pages 599–610, [link] Malbrain MLNG, Regenmortel N Van, Saugel B, et al.

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

ACEP Now

SEPTEMBER 13, 2023

In 2000, as he was completing his second term on ACEP’s Board, he was elected to the IOM – now National Academy of Medicine – in 2000. He then moved to Atlanta, to establish the Emory Center for Injury Control and later served as founding chair of Emory’s Department of Emergency Medicine. National Academics.

EMS 45

EMS Research Military Academics 45

Dr. Smith's ECG Blog

OCTOBER 17, 2024

PR depression — has been shown to be a relatively common ECG sign associated with clinically silent PE ( Kudo et al — JACC 39(12): 2000-2004, 2002 ). As often emphasized by Dr. Smith — sinus tachycardia is not a common finding with acute OMI unless something else is going on (ie, cardiogenic shock ).

EKG/ECG 77

EKG/ECG EMS Ultrasounds Shock 77

Taming the SRU

NOVEMBER 29, 2023

Lumbar puncture with xanthochromia or > 2000 RBCs in tube 4 should increase suspicion for SAH. Hemorrhagic shock is the most common etiology of instability in trauma and should always be highest on the differential. There is growing evidence that negative NCHCT + CTA outside of traditional 6-hour window is sufficient for diagnosis.

Stroke 53

Stroke EKG/ECG Resuscitation Shock 53

ETM Course

SEPTEMBER 27, 2022

We have just done this to 6 flat drills we had laying around, saving them from landfill and saving $2000 in the process.

Emergency Department 52

Emergency Department Hospitals Shock 52

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. N Engl J Med.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Pediatric Emergency Playbook

JUNE 1, 2017

The infant in shock after a ‘cold’: myocarditis Beware of the poor feeding, tachycardic, ill appearing infant who “has a cold” because everyone else around him has a ‘cold’. 2000; 35(6):618-622. That may very well be true, but any virus can be invasive with myocardial involvement. Infectious Cunningham R et al. Ann Emerg Med.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

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

Pediatric EM Morsels

JULY 21, 2023

Pediatric adjusted reverse shock index multiplied by Glasgow Coma Scale as a prospective predictor for mortality in pediatric trauma. Fun fact for animal lovers!- cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! 2008 Apr;39(4):1347-8. doi: 10.1161/STROKEAHA.107.498345.

Head Injuries 246

Head Injuries Pediatrics Outcomes Shock 246

Don't Forget the Bubbles

OCTOBER 7, 2024

Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)? Children, especially toddlers, may insert objects into outlets, leading to shocks or burns. Electrical devices used near water sources can cause severe shocks. Was the voltage high or low (as below)?

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

ACEP Now

SEPTEMBER 3, 2024

Private equity investment in health care has increased more than 20-fold since 2000, with 70 percent of this activity since 2010. He was shocked when the hospital CEO took him up on it, but a year later, volumes increased 30 percent with his emphasis on quality rather than cost-cutting.

Hospitals 113

Hospitals Radiology Radiology Administration 113

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 mg/kg (of 0.1 2x maintenance rate

Psychiatric 88

Psychiatric Seizures Emergency Department Pediatrics 88

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Perhaps, not insignificantly, they were accustomed to receiving systematized government-supplied medical and trauma care, with "shock rooms" receiving an influx of victims, as contrasted to those later who opposed "socialized medicine." Committee on Shock. Mouth-to-Airway (adjunct). Advanced Emergency Nursing Blog.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

EMDocs

OCTOBER 5, 2024

Pressors where indicated for septic shock (typically Norepinephrine starting at 0.05 2000; 6:460–3. Management 9-12 Patients such receive standard resuscitation care including: Antipyretics such as Tylenol (650-1000 mg PO), Ibuprofen (600 mg PO), or Toradol (15mg IV). IV fluid resuscitation as needed. Lee JA, Kang CI, Joo EJ, et al.

EMS 86

EMS Infectious Diseases Sepsis Hospitals 86

Pediatric Emergency Playbook

JANUARY 1, 2017

Facial grimacing is a weak indicator of pain in neonates ( Liebelt 2000 ). Unexplained tachycardia may be the early signs of shock. 2000 Aug;106(2 Pt 1):351-7. 2000; 1(4):260-269. Do not expect typical pain behaviors in neonates. Tailor your regimen to your young patient’s physiologic pitfalls and needs. Pediatrics.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

JUNE 3, 2023

4 Patients with pelvic fractures are considered unstable when systolic blood pressure < 90mmHg and heart rate >120bpm, or in those with dyspnea, altered mental status, or skin findings of shock. Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality.

Fractures 57

Fractures Resuscitation Operations EMS 57

EB Medicine

AUGUST 6, 2019

Jeff: That is simply shocking! Isaac Tawil from the University of New Mexico. Nachi: And just as with traumatic head bleeds, a small observational study of those with blunt abdominal trauma found 8% vs 30% mortality for those on DOACs vs warfarin, respectively. Let’s also talk lab studies.

Emergency Department 40

Emergency Department Stroke Wellness Administration 40

Emergency Medicine Ireland

DECEMBER 5, 2022

Expect to see this more in the cold, shocked post bypass patient or in someone who’s already having a lot of arrhythmias. 2000 Nov;28(11):3631-6. Expect to see this more in the cold, shocked post bypass patient or in someone who’s already having a lot of arrhythmias. Crit Care Med.

Shock 40

Shock Wellness 40

Taming the SRU

AUGUST 30, 2023

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. 2000 Aug;30(1):17-24. Intensive Care Med. 2021 Nov;47(11):1181-1247. doi: 10.1007/s00134-021-06506-y. Epub 2021 Oct 2. PMID: 34599691; PMCID: PMC8486643. Semin Arthritis Rheum. doi: 10.1053/sarh.2000.8366. PMID: 10966209.

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

EB Medicine

JANUARY 2, 2019

Interestingly, groups have examined outpatient care with 2 days of daily IM ceftriaxone vs inpatient IV antibiotic therapy and they found that there may be a higher than acceptable risk in the outpatient setting as several required eventual admission and one developed septic shock in their relatively small trial.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

EMDocs

MARCH 11, 2024

The clinical picture of this patient was consistent with hypovolemic shock secondary to acute cholera infection. 18 Patients with signs and symptoms of severe dehydration or shock, including stupor, coma, uncontrollable vomiting, extreme fatigue that prevents drinking, and unstable vital signs should receive IV fluid resuscitation.

Dehydration 102

Dehydration CDC Rapid Diagnostic Testing Fluid Resuscitation 102

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

Rupture can be either free wall rupture (causing tamponade) or septal rupture, causing ventricular septal defect with left to right flow and resulting pulmonary edema and shock. Fo r more on hemodynamic effects and how to manage a patient with VSR see this post: Why the sudden shock after a few days of malaise? link] [2] Oliva, P.

EKG/ECG 91

EKG/ECG Shock COPD Wellness 91