ACEP Now

AUGUST 8, 2023

Arch Dis Child Educ Pract Ed 2010; 95: 83-87. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the diagnosis and management of patients with thoracic aortic disease: executive summary. Circulation 2010; 121: 1544-1579. Clinical decision rules: how to build them. Hiratzka LF, Bakris GL, Beckman JA, et al.

Shock 52

Shock Hospitals Wellness 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2010; 26:769-781. 2010; 149(3):386-391. 2010; 45:1182-1186. 2010; 28(11):544-548. 2010 Oct;40(4):613-20. . J Emerg Med. 2012; 43(1):49-51. Martin V, Shaw-Smith C. Review of genetic factors in intestinal malrotation. Pediatr Surg Int. Nehra D, Goldstein AM. Am J Emerg Med. 2012; 30:426-431. Whitehouse et al.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Don't Forget the Bubbles

MAY 6, 2024

This multicentre retrospective cohort study looked at 202 children in California aged 1- 24 months who presented acutely between 2010 and 2021. While the use of oral corticosteroids to treat wheeze in asthma is well-established, evidence for their benefit in viral-induced wheeze is mixed.

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

Taming the SRU

OCTOBER 1, 2023

This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. J Emerg Trauma Shock. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Ann Emerg Med. 1983;12(6):411-412.

Fractures 96

Fractures COPD Hospitals Emergency Department 96

EMDocs

APRIL 22, 2024

However, as shock resolved and hemodynamic stability improved, RV strain and underfilling of the LV remained apparent 30 minutes after ROSC (Vid 4). If RV pressure is extreme, it can exceed LV pressure causing paradoxical septal wall motion toward the LV as well. 2010 Apr;38(4 Suppl):S495-501. RV pressures > LV pressures.

Ultrasounds 98

Ultrasounds Advances Cardiac Life Support (ACLS) EKG/ECG Resuscitation 98

RebelEM

JANUARY 25, 2023

2010, (Ch) 92: p 1216-1227. Am Surg 2010; 76:687-691. Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. Louis, Mosby, Inc., References Taylor MR, Lalani N.

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

Mind The Bleep

JULY 15, 2023

As well as synthesising more albumin, the liver also increases its production of LDL and VDL and lipoprotein which causes hypercholesterolaemia and hypertriglyceridaemia. Alchi B, 2010) Membranous nephropathy (MN) is characterised by the formation of immune complexes in the space between podocytes and the glomerular basement membrane.

Allergic Reactions 52

Allergic Reactions Shock Hospitals Wellness 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

The combination of abnormalities determines the category of pathophysiology: respiratory distress, respiratory failure, CNS or metabolic problem, shock, or cardiopulmonary failure. Does this child look volume depleted? Endocrine Emergencies - Could this be congenital adrenal hyperplasia with low sodium, high potassium, and shock?

Seizures 40

Seizures Sepsis Pediatrics Shock 40

RebelEM

SEPTEMBER 26, 2022

Patients from both groups are well balanced regarding results from a wide range of coagulation studies. As described in the CONSORT statement, the use of p-values in table 1 is inappropriate as the study is not powered to show a difference in baseline characteristics between the treatment and control group in an RCT (Schulz 2010).

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

Pediatric Emergency Playbook

JUNE 1, 2017

This child is at risk for expected complications, as well as overdiagnosis and iatrogenia. These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

All went well. Journal of Emergencies, Trauma and Shock, 3(1), 39. .") Another crew did have the prolapsed cord case, and resolved the issue by carrying Mom's stretcher down the stairs head-first providing steep reverse Trendelenburg's position (not clear if genupectoral position was used) to take pressure off the cord.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Perhaps, not insignificantly, they were accustomed to receiving systematized government-supplied medical and trauma care, with "shock rooms" receiving an influx of victims, as contrasted to those later who opposed "socialized medicine." Committee on Shock. 1950s & 1960s Resuscitation Research. Trimble, Tom, RN CEN.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

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. 2011 Feb 15; Epub 2010 Aug 27. Am J Respir Crit Care Med.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

PHEM Cast

SEPTEMBER 6, 2017

You can also see when your treatment is working- if you give a patient in septic shock some fluid and improve their CO, you’ll see a rise in ETC02 You can confirm adequacy of respiratory function in the fitting or post-ictal patient when all other methods fail PITFALLS Device failure- lines blocking, batteries running out, pump failure.

CPR 52

CPR Resuscitation Operations Shock 52

Downeast Emergency Medicine

APRIL 26, 2021

When looking at the subgroups with severe shock, there was an 18.5% When stratifying TXA administration time after injury and qualifying shock incidence, there appeared to be a lower 30 d mortality if TXA was given within 1 hour of the incident. Lancet 2010; 376:23-32.[ MI or stroke). 2015;527(7578):s193-197.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

PEMBlog

JUNE 5, 2024

Epub 2010 Oct 29. Infants can get a cervical spine injury during breech delivery or, unfortunately, during non accidental trauma as well. You should also consider the possibility of quote unquote spinal shock. than it is spinal shock. Factors associated with cervical spine injury in children after blunt trauma.

Fractures 52

Fractures Pediatrics Radiology Radiology 52

Pediatric Emergency Playbook

MARCH 1, 2016

On arrival, he was in compensated shock, with tachycardia. Adults tolerate hypotension relatively well, and is sufficient until we send them to the OR or interventional radiology suite. 2010 Nov;19(4):286-91. A 5-year-old boy was playing with his older brother in front of their home when he was struck by a car. 2010.07.002.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 40

Advanced Emergency Nursing from AENJ

MAY 3, 2014

Although told several times, the story of the development by Henning Ruben of the prototypical modern manual resuscitator, the self-refilling bag with unidirectional non-rebreathing valves which now dominate the world of resuscitation, is still not well-known. Committee on Shock. What were its recent antecedents? National Academies.

Resuscitation 40

Resuscitation Military Operations Emergency Nursing 40

EB Medicine

SEPTEMBER 1, 2018

You may have heard of the recommendations for incision / excision, use of venom extraction devices, tourniquets, chill methods and even electroshock therapy – well these methods are all OUT. In severe cases this can lead to systemic bleeding and even hemorrhagic shock. Jeff: Pit viper envenomation can also cause hematologic effects.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

EB Medicine

JULY 8, 2019

Jeff: Well that’s kind worrisome. Additionally, back in 2010, it was estimated that 6.6% Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in. Vitamin D, B12, Calcium, foate, iron, and thiamine deficiencies are all well documented complications. million adults!!

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. Critical Care Medicine 38():p S26-S34, February 2010. | Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. N Engl J Med. 2023 Feb 2;388(5):439-452. doi: 10.1056/NEJMra2206346.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Dr. Smith's ECG Blog

JULY 12, 2020

I found a well appearing young lady in the room with her parents who witnessed the event. Why did she go from stable to shock in seconds? In contrast, in ECG #5 ( done when the patient felt well ) normal sinus rhythm is seen, because the P wave is clearly upright in lead II, and the PR interval is normal.

EKG/ECG 40

EKG/ECG Hospitals Ultrasounds Wellness 40

EB Medicine

AUGUST 1, 2018

Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 Jeff: And the etiology of CHS is not well understood. Nachi: There is a well-studied theory here and it relates to the TRPV1 receptor that we talked about earlier. million, and cocaine at 1.9

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EB Medicine

AUGUST 6, 2019

Nachi: Well, I’m sure more of those studies are still coming. Nachi: However, in 2010, the FDA approved the first DOAC, a real game-changer. Nachi: Well that was a ton of information and background on the DOACs. Jeff: That is simply shocking! Show More v Jeff: Fair enough, we’ll take what we can get. Jeff: Agree.

Emergency Department 40

Emergency Department Stroke Wellness Resuscitation 40

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

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). While ABGs and VBGs usually correlate well, there are a few situations where this correlation is disturbed.

Emergency Department 98

Emergency Department Resuscitation COPD Shock 98

Pediatric Emergency Playbook

JANUARY 1, 2017

Assessing and managing children’s pain can be challenging, because they may not exhibit typically recognized signs and symptoms ( Srouji 2010 ). Tachycardia, tachypnea, and a change in behavior can be indicators not only to the presence of pain, but possibly to its etiology as well. Knowing the context of the episode may help.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

ACEP Now

JANUARY 13, 2024

While these discriminatory and brutal acts were shocking, they were not surprising to Black people. Dr. Vanessa Grubbs, founder of Black Doc Village, articulates this well: “a white-dominated physician training system that unjustly excludes, punishes, and dismisses Black medical students, trainees, and attending physicians will continue on.”

Leadership 52

Leadership Academics Emergency Department Shock 52

EB Medicine

JANUARY 2, 2019

A 2010 Meta-Analysis found a NPV of 99.96% when an er doc identified an IUP on bedside ultrasound. Per a 2010 and 2011 Cochrane review, there is not evidence to recommend one antibiotic over another, so let your local antibiograms guide your treatment. So keep doing your bedside scans with confidence.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

EMDocs

NOVEMBER 13, 2023

2019) argue against a minimum NIHSS score to trigger the use of CTA, instead purporting that clinical suspicion of acute ischemic stroke presenting within 24 hours of the last known well was sufficient evidence to order the study. However, IgE-mediated or not, anaphylactic shock is possible in either case. 8 The data in Mayer et al.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

PEMBlog

JANUARY 17, 2024

Well when a break in the skin occurs, normal skin, flora, and bacteria can enter the subcutaneous tissue, where they do not belong, and they can also invade the lymphatic system. You can also see petechiae and hemorrhage, as well as superficial bulla, vesicles, or even echemosis. Full blown sepsis and toxic shock syndrome.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

Sensible Medicine

AUGUST 14, 2024

In popular (lay) understanding, SIDS represents a common danger that a well-cared for and apparently healthy baby will suddenly and terrifyingly be found dead in the morning. The sudden death of an apparently healthy child is a devastating tragedy, and if it’s preventable, the costs of supine sleep may be worthwhile.

CDC 91

CDC Sepsis Research Pediatrics 91

Don't Forget the Bubbles

FEBRUARY 24, 2025

They were a well-grown, term infant born in good condition. The condition increases blood viscosity and pulmonary vascular resistance, leading to pulmonary hypertension, haemodynamic collapse, and, ultimately, death due to hypoxaemia and refractory shock. The other investigations are unremarkable, including a normal CT head.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

EMDocs

JANUARY 16, 2025

Well provide summaries of the evidence to support your decisions at the bedside. Trajectory of Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock. Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. but PPV ranges from 25.1-39.5%

Sepsis 96

Sepsis Pediatrics Shock Hospitals 96

EMDocs

JANUARY 20, 2025

1,2 For hypervolemia in heart failure patients, orthopnea >2 pillows is the most reliable clinical finding, 3,4 though an increase in peripheral edema and increased weight can be useful as well. 6-8 In patients who are on long-term hemodialysis, typical non-invasive signs of volume assessment seem to be unreliable as well.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Symptoms may be non-specific in the beginning with patients quickly developing septic shock and disseminated intravascular coagulation. 2019, 3 rd edition.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126