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Pre-Hospital Antibiotics in Sepsis?

RebelEM

Background: Sepsis remains one of the leading causes of morbidity and mortality. It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Prehospital Administration of Broad-Spectrum Antibiotics for Sepsis Patients: A Systematic Review and Meta-Analysis. Health Sci Rep 2022.

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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

Well, that time has come and it’s time to run through vasopressin. As such vasopresin exhibits the same ADH effects but this maxes out at very low doses, much lower than what we use in sepsis. Well this is where the fun beings. First up is the VASST trial, (Russel et al 2008 NEJM). How does it work? Gordon, A.

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The Latest in Critical Care, 2/5/24 (Issue #28)

PulmCCM

Fever in the ICU: Guideline Update The Society of Critical Care Medicine (SCCM) and the Infectious Diseases Society of America (IDSA) issued an interim update to their 2008 recommendations for the management of fever in the ICU. Ultrasound is well-suited for identifying most serious biliary system abnormalities.

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Diagnostics: Inflammatory Markers

Taming the SRU

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. 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. Cleland DA, Eranki AP.

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

PulmCCM

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). That could be because CIRCI is ill-defined, almost hypothetical. 3 days).

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

The Skeptics' Guide to EM

There is a certain subset of patients in septic shock whose adrenal axis functions well enough to support them in a state of health but are unable to support them in a state of unwell. The second, the larger CORTICUS study, published in the NEJM in 2008 found no benefit of the use of corticosteroids compared to placebo.

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