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

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

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

This definition includes clinically apparent seizures as well as those seen only on EEG.) Or… is it something else as well? 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.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Don't Forget the Bubbles

JUNE 10, 2024

Baby A, a preterm infant, appears to be faring well for the moment—requiring minimal respiratory support, on full feeds, without IV access, and generally in an okay condition. Systemic Infections : Sepsis and other systemic infections can predispose infants to NEC by compromising the gut barrier and promoting inflammation. Gordon, P.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Pediatric Emergency Playbook

MAY 1, 2017

Home care The neonate who is safe to go home is well appearing, and not dehydrated. Make sure to enlist the family's help and support to keep Mom hydrated, eating well, and resting whenever she can. My take away: we now have some evidence basis for using filtered sunlight as an adjunct for babies well enough to go home.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

PulmCCM

FEBRUARY 19, 2024

Well … no. In my anecdotal experience, these phrases have an impressively high positive predictive value for badness (early sepsis, often).

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

RebelEM

MARCH 27, 2023

4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. There may have very well been a policy where only RTs can make changes to a ventilator after an order was placed to ensure accurate documentation. Crit Care Explor. 2022 Feb 8; PMID: 35156050 Higgins TL et al.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

NEJM 362(9):779; March 4, 2009. As for other invasive therapies , intra-aortic balloon counterpulsation (12, 13) appears to work well in non-randomized studies, and this would also make sense: the balloon in the aorta inflates in diastole, increasing diastolic pressure and thus coronary flow. NEJM 362(9):779; March 4, 2009.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

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 91

Sepsis Fluid Resuscitation Resuscitation Shock 91

RebelEM

MAY 15, 2024

The loss of these cells leads to immunosuppression as well as decreased responsiveness of the immune system as a whole Patients with neutropenia will not only get very sick very quickly, but also will have blunted immune response and may not localize signs of infection well Fever or malaise may be their only presenting symptoms.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

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 105

Outcomes Research Pediatrics Hospitals 105

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 113

Sepsis Outcomes Administration Shock 113

EMDocs

OCTOBER 23, 2023

She had been feeling well until yesterday when she had a follow-up with her surgeon, at which time she reported that they performed an internal exam and inserted a ‘medication disk’ into her vagina. The patient is noted to be mildly tachycardic as well as febrile. 2009 Apr;49(2):198-201. Aust N Z J Obstet Gynaecol. Up to Date.

OB/GYN 93

OB/GYN Operations EMS Ultrasounds 93

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 89

Psychiatric Seizures Emergency Department Pediatrics 89

PulmCCM

JANUARY 2, 2025

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%

Sepsis 98

Sepsis Outcomes Stroke Shock 98

Don't Forget the Bubbles

NOVEMBER 6, 2024

Digital Detox and Well-Being. Update to the Neonatal Early-Onset Sepsis Calculator Utilizing a Contemporary Cohort. Rotavirus Vaccine Effectiveness Against Severe Acute Gastroenteritis: 2009-2022. Trends in C-Reactive Protein Use in Early-onset Sepsis Evaluations and Associated Antibiotic Use. Catassi G, et al.

Pediatrics 52

Pediatrics Sepsis Fractures Hospitals 52

Don't Forget the Bubbles

NOVEMBER 6, 2024

Digital Detox and Well-Being. Update to the Neonatal Early-Onset Sepsis Calculator Utilizing a Contemporary Cohort. Rotavirus Vaccine Effectiveness Against Severe Acute Gastroenteritis: 2009-2022. Trends in C-Reactive Protein Use in Early-onset Sepsis Evaluations and Associated Antibiotic Use. Catassi G, et al.

Pediatrics 59

Pediatrics Sepsis Fractures Hospitals 59