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 Outcomes 52

RebelEM

APRIL 29, 2024

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ).

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

Taming the SRU

FEBRUARY 19, 2024

This has been the central question of many research projects with variable outcomes. A recent observational study was performed to pragmatically assess clinically meaningful differences in BP in a diverse critically ill cohort with shock. Damping Damping is essentially the shock absorbers in the pressurized system. Keville, M.

Shock 59

Shock Resuscitation Ultrasounds Research 59

Mind The Bleep

OCTOBER 29, 2024

Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. Proper stabilization and detailed communication with the burns centre are essential for optimal patient outcomes. Cardiovasc Intervent Radiol 32 , 155–158 (2009). Establish IV access and begin fluid resuscitation with 250ml boluses of 0.9% 2020.0056.

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

The Skeptics' Guide to EM

DECEMBER 7, 2018

He is unsuccessfully shocked. There was also no increase in survivors with good neurological outcomes with ACLS. JAMA 2009, Hagihara et al. Clinical Question: Does the use of epinephrine in cardiac arrest improve survival rates with a favourable neurological outcome? JAMA 2012 and Cournoyer et al.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

EMDocs

JANUARY 16, 2024

Patients can have excellent outcomes despite prolonged resuscitation. Down time and time doing CPR is not nearly as important, and even patients with low end tidal, fixed, dilated pupils, asystole rhythm, and extended low-flow times can have favorable neurologic outcomes. Published 2009 Jun 10. 2009;338:b2085. Carsten L, et al.

Hyperthermia / Hypothermia 84

Hyperthermia / Hypothermia Resuscitation CPR EMS 84

RebelEM

NOVEMBER 3, 2022

Albert 2011, Jabre 2009) However, the existing literature comparing etomidate and ketamine is conflicting. Outcomes: Primary Outcome: Incidence of post-induction hypotension Secondary Outcome : First-pass success rate of endotracheal intubation Primary Results: 84 articles were identified for potential inclusion.

Outcomes 52

Outcomes Emergency Department Sepsis Operations 52

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. 4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. This is a critical error that leads to poorer outcomes for patients in need of critical care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

The Skeptics' Guide to EM

FEBRUARY 10, 2018

In 2009, a study by Panickar et al found no positive effect in giving steroids to pre-school children with wheeze (2). Outcome: * Primary: Length of stay in the hospital * Secondary: Re-attendance; readmission; salbutamol usage; and residual symptoms after discharge Dr. .

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

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.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

PHEM Cast

APRIL 18, 2016

Blackham & Benger, 2009. The periscope video of the SKEPTIC trial presentation is accessible here: [link] The Royal Flying Doctors Service (RFDS) use infusion of ketamine to manage agitated mental health patient without need for intubation. Muscle spasm is superior to any artificial method.

Fractures 40

Fractures Administration Operations Shock 40

Dr. Smith's ECG Blog

JULY 18, 2014

such Q-waves are associated with larger MI and worse outcomes (2. Case Continued 2 days later the patient became increasingly tachycardic, hypotensive, ashen, clammy (in cardiogenic shock) and had a new murmur. Apr 28, 2009. Very unlikely. Although acute anterior STEMI frequently has narrow QR-waves within one hour of onset (1.

EKG/ECG 52

EKG/ECG Shock Ultrasounds Wellness 52

Pediatric Emergency Playbook

AUGUST 1, 2017

Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease? Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. 2009; 197:211-215. 2009 Jun;123(6):1548-55 Chinn WM, Zavala DC, Ambre J. J Med Genet 2008; 45:1. Arshad A, Powell C, Tighe MP.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

EMDocs

JUNE 3, 2023

4 Patients with pelvic fractures are considered unstable when systolic blood pressure < 90mmHg and heart rate >120bpm, or in those with dyspnea, altered mental status, or skin findings of shock. Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality.

Fractures 54

Fractures Resuscitation Operations EMS 54

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 mg/kg (of 0.1 2x maintenance rate

Psychiatric 88

Psychiatric Seizures Emergency Department Pediatrics 88

EMDocs

DECEMBER 18, 2023

Septic shock is high on the differential diagnosis for this patient’s presentation. Introduction Sepsis and septic shock are life-threatening conditions characterized by severe systemic inflammation and organ dysfunction due to a dysregulated host response to infection. What are the most up-to-date guidelines for managing this patient?

Sepsis 65

Sepsis Fluid Resuscitation Resuscitation Shock 65

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

DECEMBER 16, 2023

Heat stroke can lead to end-organ dysfunction such as rhabdomyolysis, disseminated intravascular coagulation, cardiogenic shock, liver failure, and cerebral edema. Broad-spectrum antibiotics (A) for septic shock are not inappropriate given the hyperthermia, tachycardia, and hypotension. BMC research notes , 8 , 758. link] Swee, duS.,

Hyperthermia / Hypothermia 68

Hyperthermia / Hypothermia EMS Stroke Seizures 68

RebelEM

MAY 15, 2024

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. Neutropenic Fever: Fever (one reading of 38.3C Give appropriate fluids, vasopressors, and antibiotics. 2014;14:162.

Infectious Diseases 105

Infectious Diseases Administration Sepsis Anaphylaxis 105

RebelEM

NOVEMBER 11, 2024

compared cefepime to piperacillin-tazobactam in a cohort of 250 patients with septic shock and found a signal toward higher mortality in those receiving cefepime. Variations in compliance could have impacted patient outcomes. In 2021, Buckley et. 3 The same year, Ross et. Discussion: Gut Microbiome ?

Sepsis 84

Sepsis Outcomes Administration Shock 84

EMDocs

NOVEMBER 13, 2023

2 Outcomes of patients presenting with ischemic stroke who received MRI as initial imaging modality have demonstrated similar outcomes to those with initial CTA, with Kim et al. demonstrating that functional outcome at 3 months did not differ between the CTA and MRI groups (38.5% vs. 38.1%) with a good functional outcome.

Stroke 86

Stroke Radiology Radiology Emergency Department 86