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Glasgow Coma Scale in Children

Pediatric EM Morsels

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!-

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Pre-Hospital Antibiotics in Sepsis?

RebelEM

It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Three outcomes were evaluated, with none being deemed the primary outcome. Background: Sepsis remains one of the leading causes of morbidity and mortality. to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

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The Latest in Critical Care, 2/12/24 (Issue #29)

PulmCCM

SCCM Guideline Update: Steroids for Community-Acquired Pneumonia, ARDS, Septic Shock Steroids are good medicine in the ICU, U.S. SCCM made its statement unilaterally, without the European Society of Intensive Care Medicine (ESICM), its partner on the 2008 and 2017 updates, or the American Thoracic Society (ATS).

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SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock

The Skeptics' Guide to EM

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. He writes an […] The post SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock first appeared on The Skeptics Guide to Emergency Medicine. Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. NEJM January 2018.

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Review of the ATHOS 3 trial

Northwestern EM Blog

The ATHOS-3 trial in 2017 explored the efficacy of angiotensin II as a vasopressor for severe vasodilatory shock. Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation.

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The Latest in Critical Care, 10/30/23 (Issue #18)

PulmCCM

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).

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Tasty Morsels of Critical Care 075 | Vasopressin

Emergency Medicine Ireland

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.

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