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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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Is procalcitonin "safe" to guide antibiotic use in patients with sepsis?

PulmCCM

A large proportion have concluded PCT is a safe and effective method to shorten antibiotic courses, including in patients with sepsis. The ADAPT-Sepsis Trial Between 2018 and 2024 at 41 centers in the U.K., Because ADAPT-Sepsis was designed as a noninferiority trial, and the authors chose (arbitrarily) a 5.4%

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EM@3AM: Amniotic Fluid Embolism

EMDocs

The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. Romero (2009). “Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation.” A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. RR 28, SpO2 89% on 6L NC.

EMS 96
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PEMPix 2023 Online Case 3: The Only Thing We Have to Fear

PEMBlog

The night prior to presentation, mom noticed he was not feeding as well and seemed fussy. Initially in the emergency department he was generally well-appearing with normal vital signs. rectally, prompting a sepsis workup given his age. This patient was hospitalized for 4 days where he remained well-appearing. Nishida, H.,

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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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Steroids in preschool wheeze

Don't Forget the Bubbles

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 105
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The CLOVERS Trial

Taming the SRU

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. N Engl J Med. 2023;388(6):499-510. 2018, Kuttab, Lykins et al.

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