2004, EMS and Shock - Emergency Care Today

Adjunctive Methylene Blue in Septic Shock?

RebelEM

MAY 29, 2023

septic shock). Limited, small studies on its use in septic shock do not make a clear argument for use. Early Adjunctive Methylene Blue in Patients with Septic Shock: A Randomized Controlled Trial. Background: Sepsis can induce numerous physiologic derangements. Paper: Ibarra-Estrada, M et al. Crit Care 2023. 95% CI 15.4

Shock

Shock Fluid Resuscitation Sepsis Resuscitation

IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

RebelEM

FEBRUARY 24, 2025

13 That is to say nothing of the effect that the type and response to shock has on the individual patients involved in these studies. As seen in the Andromeda Shock Trial, and multiple other trials involving shocked patients, capillary return also reigns supreme regarding physical examination. Mar 2004; PMID: 15090949.

Ultrasounds

Ultrasounds Shock Fluid Resuscitation Resuscitation

Glasgow Coma Scale in Children

Pediatric EM Morsels

JULY 21, 2023

We had just received a young child from EMS who was post-ictal with decreased mentation. Pediatric adjusted reverse shock index multiplied by Glasgow Coma Scale as a prospective predictor for mortality in pediatric trauma. The post Glasgow Coma Scale in Children appeared first on Pediatric EM Morsels. Less than 8, intubate!

Head Injuries

Head Injuries Pediatrics Outcomes Shock

Webinars

Bridging Innovation & Patient Care: The Growing Role of AI

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Clinical Conundrums: Should You Give the First Dose of Antibiotics IV Before Discharging Home on Oral Antibiotics?

RebelEM

JANUARY 9, 2024

You decide she is stable to be discharged home on levofloxacin (See REBEL EM for antibiotic coverage in CAP ) but consider giving her a first dose intravenously. Except for patients with poor gut absorption or those with critical infectious processes such as septic shock or necrotizing fasciitis, this belief appears to be unfounded.

Infectious Diseases

Infectious Diseases Pediatrics EMS Administration

An Herbal Hope: Is XBJ A Game-Changer in Sepsis Management?

RebelEM

AUGUST 14, 2023

4 XBJ received approval from the China Food and Drug Administration in 2004, 2 although the FDA of the United States has not approved it. in both groups Mean APACHE II score was 12 in both groups Almost half of the patients had septic shock at enrollment Mean time from sepsis identification to randomization was 1.4

Sepsis

Sepsis Outcomes Administration EMS

What are treatment options for this rhythm, when all else fails?

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The patient in today’s case presented in cardiogenic shock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. Written By Magnus Nossen — with edits by Ken Grauer and Smith.

EKG/ECG

EKG/ECG Shock Hospitals Sepsis

REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

RebelEM

JANUARY 29, 2024

appeared first on REBEL EM - Emergency Medicine Blog. in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 PMID: 21422387 Wan S et al. Thrombolysis Compared with Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials. PMID: 15262836 Sharifi M et al.

Stroke

Stroke Outcomes Hospitals Administration

Vasopressor Nonresponse

Northwestern EM Blog

JANUARY 24, 2022

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

Anaphylaxis

Anaphylaxis Shock Sepsis Resuscitation

Two patients with chest pain and RBBB: do either have occlusion MI?

Dr. Smith's ECG Blog

OCTOBER 17, 2024

The paramedic notes called STEMI into question: “EMS disagree with monitor for STEMI callout. With both EMS and ED computer interpretations reading ‘STEMI’, the emergency physician activated the cath lab. Comparing J-point between leads noted no significant ST elevation or depression, with QRS prolongation from RBBB.”

EKG/ECG

EKG/ECG EMS Shock Ultrasounds

The Technologically Dependent Child in the ED

Pediatric Emergency Playbook

OCTOBER 1, 2015

EMS is bringing you a child with a VP shunt, port-a-cath, trached on a vent, seizing, hypotensive, and now desaturating – ETA – 3 minutes. He is in compensated shock. Pediatr Clin N Am 51 (2004) 305– 325 Kusminsky RE. Eur Respir J 2004; 23: 430–434 Shinkwin CA, Gibbin KP. Are you ready? Medicine is evolving.

Pediatrics

Pediatrics Fractures Resuscitation Burns

ABG Versus VBG in the Emergency Department

EMDocs

FEBRUARY 12, 2024

Authors: Rachel Kelly, MD ( EM Resident Physician, Stony Brook University Hospital); Robert Nocito, MD (EM Attending Physician, Stony Brook University Hospital) // Reviewed by: Jessica Pelletier, DO (EM Education Fellow, Washington University in St. 2004 Nov;30(11):2017-20. Epub 2004 Jul 24. 2004 Sep;70(9):805-10.

Emergency Department

Emergency Department Resuscitation COPD Shock

REBEL Core Cast 122.0 – Neutropenic Fever

RebelEM

MAY 15, 2024

Epub 2011 Apr 22 Coyne CJ, Le V, Brennan JJ, Castillo EM, Shatsky RA, Ferran K, Brodine S, Vilke GM. Rezaie, MD (Twitter/X: @srrezaie ) The post REBEL Core Cast 122.0 – Neutropenic Fever appeared first on REBEL EM - Emergency Medicine Blog. Neutropenic Fever: Fever (one reading of 38.3C British Journal of Haematology.

Infectious Diseases

Infectious Diseases Administration Sepsis Anaphylaxis

Traveling Ticks: Tickborne Illnesses and International Travel

Pediatric EM Morsels

APRIL 5, 2024

Jensenius 2004) Let’s take a moment to review Tickborne Illnesses and International Travel : Tickborne Illnesses and Major Rickettsial Diseases: Basics Most of these illnesses are acquired from exposure to a rural area during travels including camping, hiking, safaris, and livestock.

CDC

CDC Infectious Diseases Pediatrics Shock

emDOCs Revamp – Acute Chest Syndrome

EMDocs

JUNE 27, 2024

Sundd P, Gladwin MT, Novelli EM. 2004 Jul;15(4):248-250. May substitute levofloxacin if allergic to cephalosporin Anti-viral medications if indicated Oseltamivir for influenza Patients >14 days old Remdesivir for COVID Patients >28 days old and at least 7lbs (3.2 2020 Feb 12;10(1):2470. PMID: 32051480; PMCID: PMC7015921.

Pediatrics

Pediatrics Dehydration EMS Hospitals

IV fluids in the ED: When do we really need them?

EMDocs

JANUARY 20, 2025

Patients were enrolled in these trials if they had signs of shock, with mortality ranging from 18-29%. 13 While there is good data that early antibiotics for patients in septic shock reduce mortality 18-19 the role of early and aggressive volume resuscitation and its impacts on patient-centered outcomes remain unclear. Inwald et al.

Dehydration

Dehydration Fluid Resuscitation Sepsis Resuscitation

Emergency Care Today

Adjunctive Methylene Blue in Septic Shock?

IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

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Glasgow Coma Scale in Children

Webinars

Clinical Conundrums: Should You Give the First Dose of Antibiotics IV Before Discharging Home on Oral Antibiotics?

An Herbal Hope: Is XBJ A Game-Changer in Sepsis Management?

What are treatment options for this rhythm, when all else fails?

REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

Vasopressor Nonresponse

Two patients with chest pain and RBBB: do either have occlusion MI?

The Technologically Dependent Child in the ED

ABG Versus VBG in the Emergency Department

REBEL Core Cast 122.0 – Neutropenic Fever

Traveling Ticks: Tickborne Illnesses and International Travel

emDOCs Revamp – Acute Chest Syndrome

IV fluids in the ED: When do we really need them?

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