2006 Outcomes Shock 
Pediatric EM Morsels
JULY 21, 2023
Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. Fun fact for animal lovers!-
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)?
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PHEM Cast
APRIL 16, 2018
The outcomes from different resuscitative interventions in a haemorrhagic shock model in porcine model: From: Watts et al. Use of CPR in hemorrhagic shock, a dog model. Annals of Emergency Medicine; 2006. Survival and neurological outcome after OOH TCA in pediatric & adult populations: a systematic review.
PulmCCM
OCTOBER 9, 2023
Intensive blood glucose control in the ICU: Try, try again (TGC-FAST trial) Hyperglycemia is associated with worse outcomes in the ICU (and in medical patients generally), so correcting it must improve outcomes … right? ICU lengths of stay (the primary outcome) were identical between groups. and many other countries.
PHEM Cast
APRIL 10, 2016
This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. Arriving by Emergency Medical Services Improves Time to Treatment Endpoints for Patients With Severe Sepsis or Septic Shock. 2006 Jun 3;332(7553):1295–8.
EB Medicine
OCTOBER 1, 2018
This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. That’s where we’re at.
Pediatric Emergency Playbook
APRIL 1, 2016
There are two main reasons for an elevated lactate: the stress state and the shock state. The shock state is due to tissue hypoxia, seen in septic shock. We could use it to track treatment , and see if we can clear the lactate; decreased lactate levels are associated with a better outcome in adults. Clinical Chemistry.
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