Sensible Medicine

JULY 17, 2023

COURAGE sent shocks through the cardiology world: No difference. And again, they reported no difference in outcomes. A year later, in 2008, COURAGE trialists published a follow-up paper looking at quality of life. The choice to name the trial COURAGE was apt as this was the heyday for PCI and stents. Followup was nearly 5 years.

Shock 80

Shock Outcomes 80

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

The notes now refer to the patient being in cardiogenic shock, on pressors. hours from presentation, where he was found to have an acute thrombotic LAD occlusion which was stented with resulting TIMI 3 flow, but still the patient was in severe cardiogenic shock. Time = 3 hours: the next troponin returns at 60 ng/L.

EKG/ECG 87

EKG/ECG Shock Documentation/Coding Academics 87

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

Emergency Medicine Ireland

OCTOBER 30, 2023

First up is the VASST trial, (Russel et al 2008 NEJM). Primary outcome here was kidney based rather than mortality. Vasopressin versus norepinephrine infusion in patients with septic shock. New Engl J Medicine 358 , 877–87 (2008). First up is the VASST trial, (Russel et al 2008 NEJM). Nagendran 2019 in CCM.

Shock 52

Shock Sepsis Wellness Outcomes 52

ACEP Now

SEPTEMBER 3, 2024

These stakeholders are similarly shielded in court when adverse patient outcomes, such as negligent deaths, occur under their management or when the bought-out companies are challenged for anticompetitive business practices overseen by the PE firm. 7-9 The PE model then aims to sell acquired businesses for a profit within three to six years.

Hospitals 113

Hospitals Radiology Radiology Administration 113

Pediatric Emergency Playbook

AUGUST 1, 2017

J Med Genet 2008; 45:1. Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease? J Pediatr Gastroenterol Nutr 2008; 46:13. Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. 2008; 15-21. 2008; 22-28. Hirschsprung's disease.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Thinking Critical Care

MAY 18, 2023

In 1983 I was an Englishman abroad, the London anaesthetist who was appointed to be the English anaesthetist on the Shock Team only because the outstanding candidate from Oxford had preferred to take up a job doing muscle relaxant research with Kitz and Katz in the USA. 4] The research agenda at the time was broad.

Shock 40

Shock Research Sepsis Resuscitation 40

Dr. Smith's ECG Blog

OCTOBER 6, 2023

Thus, this ECG predicts poor myocardial perfusion and poor outcome. His included cardiogenic shock, V Tach, AV block. de Winter et al in N Engl J Med 359:2071-2073, 2008. Small vessel occlusion is measured by "blush" on the angiogram, and codified by TIMI Myocardial Perfusion (TMP) Grading. He was hospitalized for 16 days.

EKG/ECG 70

EKG/ECG Academics Shock Outcomes 70

Taming the SRU

AUGUST 30, 2023

A 2008 review in the International Journal of Medicine on spinal epidural abscess (SEA) agreed that inflammatory markers (specifically ESR and CRP) are generally sensitive in the diagnosis of SEA, but are not specific. 2008 Aug;75(8):557-66. Notably, up to 40% of patients with native vertebral osteomyelitis had a normal WBC [33-34].

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

EB Medicine

MAY 3, 2019

Jeff: And finally, how many of you wish there was a clearly outlined evidence-based approach to managing such patients to improve care and outcomes? Jeff: If those figures seem a bit high, another CDC study found that in a general population survey of a quarter million people between 2006-2008, 9% met the criteria for major depression.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

EB Medicine

JULY 8, 2019

From the 80’s to 2008, the worldwide prevalence of obesity nearly doubled! Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause. with generally good clinical outcomes including improved quality of life and reducing or staving off comorbidities. million adults!!

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EMDocs

JANUARY 20, 2024

Symptoms of heart failure and cardiogenic shock may develop in more severe cases. Patients with features of shock may require vasopressors, and the decision on the specific drug hinges on the presence or absence of left ventricular outflow tract (LVOT) obstruction.

EMS 74

EMS Fluid Resuscitation Shock EKG/ECG 74

EMDocs

JANUARY 4, 2024

Cardiogenic shock and hypotension can occur (systolic heart failure with reduced ejection fraction.) 10,12 Refractory shock or malignant arrhythmias occur in < 5% of patients. Whole bowel irrigation: 3 Not routinely performed and limited evidence to support improved outcome in general. 2008 Apr;51(4):412-5, 415.e1.

Seizures 66

Seizures EKG/ECG Poisoning Shock 66

RebelEM

MAY 15, 2024

2008 Sep;1138:329-50. Changing aetiology, clinical features, antimicrobial resistance, and outcomes of bloodstream infection in neutropenic cancer patients. Time to antibiotics and outcomes in cancer patients with febrile neutropenia. Give appropriate fluids, vasopressors, and antibiotics. Ann Emerg Med. 2017 Jun;69(6):755-764.

Infectious Diseases 93

Infectious Diseases Administration Sepsis Anaphylaxis 93

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.

Dehydration 57

Dehydration Fluid Resuscitation Sepsis Resuscitation 57