Don't Forget the Bubbles

JUNE 10, 2024

Systemic Infections : Sepsis and other systemic infections can predispose infants to NEC by compromising the gut barrier and promoting inflammation. Differential diagnoses include septic ileus, and infection causes such as sepsis, meningitis and pneumonia. How do we diagnose necrotising enterocolitis? Fitzgibbons, S.C., Gordon, P.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Don't Forget the Bubbles

JULY 22, 2024

The most recent meta-analysis , published in 2016 (comparing eleven studies from 1986 to 2009), struggled to reach a consensus because the trials were too heterogeneous to make robust conclusions. 2009 Jan 22;360(4):329–38. So, an up-to-date, high-quality meta-analysis iss much needed. Fortunately, Lee et al. N Engl J Med.

Outcomes 104

Outcomes Research Pediatrics Hospitals 104

EMDocs

DECEMBER 18, 2023

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. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician. vs. 0.91), positive predictive value (0.27

Sepsis 66

Sepsis Fluid Resuscitation Resuscitation Shock 66

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9% Do not prepare a sterile field (but be as clean as possible). Do not transport to an alternative location.

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

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). It is really common during the winter months and often due to a viral infection (1). There has always been some uncertainty about the benefit of prednisolone for viral wheeze in pre-school children.

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

PulmCCM

FEBRUARY 19, 2024

In my anecdotal experience, these phrases have an impressively high positive predictive value for badness (early sepsis, often). I learned a long time ago to become highly vigilant if a family member says “something’s different,” “she’s not right,” “something’s wrong,” etc.

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

Pediatric Emergency Playbook

APRIL 1, 2016

Lactate A sick child with sepsis syndrome? In the adult literature, we know that a lactate level above 4 mmol/L in patients with severe sepsis was associated with the need for critical care. The acute recognition and treatment of sepsis is first and foremost, clinical. The short answer – yes.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

RebelEM

NOVEMBER 3, 2022

Albert 2011, Jabre 2009) However, the existing literature comparing etomidate and ketamine is conflicting. The groups were unbalanced, with more patients with sepsis and more patients with difficult airway characteristics in the ketamine group. Van Berkel 2017) In 2020 the NEAR study reported peri-intubation hypotension rates of 18.3%

Outcomes 52

Outcomes Emergency Department Sepsis Operations 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2009; 197:211-215. 2009 Jun;123(6):1548-55 Chinn WM, Zavala DC, Ambre J. Evid Based Rev Surg. 2013;216(3):501-505. Petroianu A. Diagnosis of acute appendicitis. Int J Surg. 2012; 10:115-119. Mazeh H et al. Tip appendicitis: clinical implications and management. Amer J Surg. Puig S et al. Semin Roentgenol. 2008; 22-28. Pediatrics.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

RebelEM

MARCH 27, 2023

4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. Patients at risk for ARDS were stratified by the Lung Injury Prevention Score (LIPS) which predicts the probability of developing ARDS and subsequent mortality. Crit Care Explor. 2022 Feb 8; PMID: 35156050 Higgins TL et al.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Pediatric status epilepticus is analogous to the multi-organ dysfunction syndrome in severe sepsis. October 8th, 2009. This is the second reason to act quickly and avoid this kindling effect. In other words – time is brain. Or… is it something else as well? Status epilepticus affects almost every organ system. ACEP Scientific Assembly.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Dr. Smith's ECG Blog

JANUARY 1, 2013

Fourth , patients with reasons to have demand ischemia (tachycardia, sepsis, GI Bleed, etc.) Blackwell Publishing 2009. Third , patients at higher risk of NSTEMI (older, more risk factors, h/o angiogram with multivessel disease) are much more likely to have subendocardial disease (vs. younger smoker). O’laughlin, MD, and edited by me.

EKG/ECG 52

EKG/ECG Sepsis 52

Pediatric Emergency Playbook

MAY 1, 2017

Check the bilirubin in any neonate you are working up for sepsis. 2009; 124(4):1193-6. The neonate may be sleepy but hypotonic or have a high-pitched cry; he maybe irritable or inconsolable, jittery or lethergic. The dehydration and neurologic dysfnction from the hyperbilirubinemia may even cause fever. Pediatrics in Review.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Taming the SRU

NOVEMBER 13, 2024

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 Emergency Department Seizures Pediatrics 88

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

NEJM 362(9):779; March 4, 2009. For instance: sepsis, bleeding, dehydration, hypoxia, and mild ACS. NEJM 362(9):779; March 4, 2009. Dobutamine may be preferred in patients without severe hypotension who have high vascular resistance. -- De Backer D et al. Comparison of Dopamine and Norepinephrine in the Treatment of Shock.

EKG/ECG 52

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 52

RebelEM

NOVEMBER 11, 2024

Background: Patients with sepsis are routinely treated with empiric broad-spectrum antibiotics while awaiting source identification, as recommended by the surviving sepsis campaign.2 Mortality of Patients With Sepsis Administered Piperacillin-Tazobactam vs Cefepime. address in the article discussed below. JAMA Intern Med.

Sepsis 84

Sepsis Outcomes Administration Shock 84

RebelEM

MAY 15, 2024

Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. Improving the immediate management of neutropenic sepsis in the UK: Lessons from a national audit. Neutropenic Fever: Fever (one reading of 38.3C Support Care Cancer. 2018 May;26(5):1465-1470. doi: 10.1007/s00520-017-3985-0. Clarke, R.

Infectious Diseases 105

Infectious Diseases Administration Sepsis Anaphylaxis 105

EMDocs

OCTOBER 23, 2023

This may also predispose a patient to sepsis, peritonitis, or bowel infarction, which need to be recognized quickly. 2009 Apr;49(2):198-201. It may present with vaginal bleeding (the most common presenting symptom) (3), or watery vaginal discharge (2,6). Tan JJ, Tsaltas J, Hengrasmee P, Lawrence A, Najjar H. Aust N Z J Obstet Gynaecol.

OB/GYN 67

OB/GYN Operations EMS Ultrasounds 67