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 52

Anaphylaxis Shock Sepsis Resuscitation 52

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 98

Sepsis Outcomes Administration EMS 98

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 73

EKG/ECG EMS Shock Ultrasounds 73

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

The combination of abnormalities determines the category of pathophysiology: respiratory distress, respiratory failure, CNS or metabolic problem, shock, or cardiopulmonary failure. Does this child look volume depleted? Endocrine Emergencies - Could this be congenital adrenal hyperplasia with low sodium, high potassium, and shock?

Seizures 40

Seizures Sepsis Pediatrics Shock 40

Pediatric Emergency Playbook

AUGUST 1, 2017

2004; 199(4):628-635. 2004 Aug;44(2):131-7. Intestinal Malrotation in Children: A Problem-Solving Approach to the Upper Gastrointestinal Series. Radiographics. 2006; 26:1485-1500. Kapfer SA, Rappold JF. Intestinal Malrotation – Not Just the Pediatric Surgeon’s Problem. J Am Coll Surg. Lee HC et al. J Emerg Med. 2012; 43(1):49-51.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 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’. 2004; 90:e17. 2004; 110:e511-e513. 2004; 114(2):255-258. Chacko P et al. 2004; 89:359-362. African Health Sci. 2014; 14(1): 23-227.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Pediatric Emergency Playbook

OCTOBER 1, 2015

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. The Huber needle is not a resuscitative line. Obtain proper access to give fluids -- do not rely on the port-a-cath. Vascular devices are notoriously troublesome. Hydrocephalus. J Am Coll Surg.

Pediatrics 40

Pediatrics Fractures Resuscitation Burns 40

Taming the SRU

AUGUST 30, 2023

Bacterial Meningitis: IDSA guidelines for 2004 report that a normal CRP value has a high negative predictive value for bacterial meningitis, but sensitivities and specificities vary between studies [35]. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Cleve Clin J Med. PMID: 18756836.

Infectious Diseases 89

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

PulmCCM

OCTOBER 16, 2023

per 1,000 catheter-days in a 2004 analysis across Michigan (or about 1 infection for every 40 people with a CVC for 10 days). Most CLABSIs are Preventable, and It Matters The strongest evidence for the potential to reduce central line bloodstream infections came from the Michigan Keystone ICU project. CLABSI rates were about 2.5

CDC 52

CDC Hospitals Ultrasounds Documentation/Coding 52

Pediatric Emergency Playbook

MAY 1, 2017

He will be dehydrated – possibly in shock. 2004; 114(1). My take away: we now have some evidence basis for using filtered sunlight as an adjunct for babies well enough to go home. Critical Care Although rare, the critically ill neonate with hyperbilirubinemia requires immediate intervention. He will be irritable. Pediatrics.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

PHEM Cast

SEPTEMBER 6, 2017

trauma 2004) showed that end-tidal CO2 may be of value in predicting outcome from major trauma (19). Qvigstad et al showed in again in Resuscitation in 2013, confirming inter-individual variation in effectiveness of CPR using ETCO2 as a surrogate for CO Trauma Deakin et al. (J.

CPR 52

CPR Resuscitation Operations Shock 52

EMDocs

FEBRUARY 12, 2024

First, there can be a poor correlation between venous and arterial gases in states of shock, hemodynamic instability, or extremes of acid-base disturbances, due to poor cardiac output/circulatory failure impairing venous and arterial flow, with associated poor gas exchange as well as hypercapnia and acidemia at the tissue level (8).

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

RebelEM

MAY 15, 2024

Neutropenic Fever: Fever (one reading of 38.3C Give appropriate fluids, vasopressors, and antibiotics.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

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 164

CDC Infectious Diseases Pediatrics Shock 164

PulmCCM

SEPTEMBER 23, 2021

Guarracino F, Ferro B, Morelli A, Bertini P, Baldassarri R, Pinsky MR: Ventriculoarterial decoupling in human septic shock. New England Journal of Medicine 2004, 351(11):1097-1105. Landesberg G, Gilon D, Meroz Y, Georgieva M, Levin PD, Goodman S et al : Diastolic dysfunction and mortality in severe sepsis and septic shock.

Stroke 40

Stroke Sepsis Shock Ultrasounds 40

Pediatric Emergency Playbook

JANUARY 1, 2017

mg/kg IV, up to 10 mg ) ( Brousseau 2004 ), often given with diphenhydramine (1 mg/kg PO or IV, up to 50 mg) and IV fluids. Unexplained tachycardia may be the early signs of shock. 2004 Feb;43(2):256-62. True migraine headache may be treated with all of the above, and rescue therapy may include prochlorperamide (0.15

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EMDocs

JUNE 27, 2024

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 Dourakis SP, Alexopoulou A, Papageorgiou C, Kaloterakis A, Hadziyannis SJ. Eur J Intern Med.

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97

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 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75