PEMBlog

JANUARY 17, 2024

2011 Mar;127(3):e573-80. Epub 2011 Feb 21. Clin Infect Dis 2011; 52:e18. Full blown sepsis and toxic shock syndrome. Well, you definitely shouldn’t be sending a blood culture because if you’re worried about bacteremia and sepsis, that kid needs to stay in the hospital. Pediatrics. doi: 10.1542/peds.2010-2053.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

Mind The Bleep

AUGUST 5, 2023

Common signs and symptoms include: Abdominal distention with prominent veins and discolouration Umbilical flaring Poor feeding Bilious vomiting Abdominal tenderness Bowel changes, including diarrhoea, blood and mucus Lethargy, apnoea, bradycardia Sepsis Risk factors of low birth rate, prematurity and formula feeding. (1, Updated 2022 Aug 8].

Sepsis 52

Sepsis Ultrasounds Radiology Radiology 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2011; 364(3):255-264. 2011; 29:1136-1140.:205-211. 2011; 523-527. 2011; 24: 552-561. 2011; 146(6):660-665. Necrotizing Enterocolitis. N Eng J Med. Niño DF et al. Necrotizing enterocolitis: new insights into pathogenesis and mechanisms. 2016; 13:590-600. Walsh MC et al. Am J Emerg Med. Chien M et al. J Emerg Med.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

RebelEM

JANUARY 29, 2024

Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension: A Scientific Statement from the American Heart Association. PMID: 21422387 Wan S et al. Circ 2004.

Stroke 137

Stroke Outcomes Hospitals Administration 137

Mind The Bleep

SEPTEMBER 17, 2024

Always consider management as per ATLS protocol and SEPSIS 6 if relevant. Management The management is guided by the examination findings which are covered in the respective chapter, this section will delve into the importance of a number of those steps, as well as further long-term care. Ensure the wound has been adequately washed out.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

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? Necrotizing enterocolitis.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Pediatric Emergency Playbook

JUNE 1, 2016

Distributive Shock The most common cause of distributive shock is sepsis, followed by anaphylactic, toxicologic, adrenal, and neurogenic causes. Children with sepsis come in two varieties: warm shock and cold shock. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012.

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Dr. Smith's ECG Blog

JULY 21, 2024

The stay in the cardiac intensive care unit (CICU) was further complicated by sepsis, delirium, GI bleeding, and anuric renal failure with need for renal replacement therapy. Unfortunately, he required re-intubation a few days later due to respiratory distress from severe bilateral pneumonia.

EKG/ECG 116

EKG/ECG Shock Hospitals Sepsis 116

PulmCCM

SEPTEMBER 9, 2021

Yet in 2011 a landmark randomized, controlled trial measured the effect that an intravenous bolus had on mortality in children with severe febrile illness in 3 African countries. sepsis – defined as suspected or confirmed infection plus acute organ dysfunction; d.] needed at least 1 fluid expansion, 2.] older than 65 years; b.]

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

Dr. Smith's ECG Blog

AUGUST 23, 2017

Slow atrial flutter (flutter rate 240, ventricular rate 120) Misdiagnosed as sinus tach Here is the case: Sepsis with Pulmonary Edema and Elevated Right Sided Pressures Atrial Flutter rate: Atrial flutter is usually at a rate of 300, but can be anywhere between 240 and 360. Thus the flutter rate is 270 with 2:1 conduction.

Stroke 52

Stroke Sepsis Emergency Department EMS 52

Mind The Bleep

FEBRUARY 9, 2024

48 hours) to help her through the initial period of sepsis while her antibiotics take time to work. 2011 Dec;11(6):601-4. It is important to set out the goals for that patient’s ICU stay, and also the limits of care. Some examples of this; A 68 year-old lady being admitted for monitoring and a limited amount of vasopressors (e.g.

Hospitals 52

Hospitals Resuscitation Fluid Resuscitation Shock 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

RebelEM

MARCH 27, 2023

4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. 2011 Feb 15; Epub 2010 Aug 27. Patients at risk for ARDS were stratified by the Lung Injury Prevention Score (LIPS) which predicts the probability of developing ARDS and subsequent mortality. PMID: 19325480 Gajic O, et al.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Dr. Smith's ECG Blog

APRIL 15, 2019

A previous ECG from 4 years prior was normal: This looks like an anterior STEMI, but it is complicated by tachycardia (which can greatly elevate ST segments) and by the presentation which is of fever and sepsis. In this abstract from 2011, we found that 4%(4 of 99) type 2 MI and 38% of type 1 MI had ST Elevation.

EKG/ECG 52

EKG/ECG Sepsis Documentation/Coding Shock 52

Pediatric Emergency Playbook

NOVEMBER 1, 2015

Case 1: Sepsis Laura is a 2-month-old baby girl born at 32 weeks gestational age who today has been “breathing fast” per mother. She is in respiratory failure from bronchiolitis and likely viral sepsis. Induction Agent in Sepsis The consensus recommendation for the induction agent of choice for sepsis in children is ketamine.

Shock 40

Shock Sepsis Airway Management Pediatrics 40

Pediatric Emergency Playbook

MAY 1, 2017

Check the bilirubin in any neonate you are working up for sepsis. 2011; 128(4):825-31. 2011; 32(8):341-9. 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.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Pediatric status epilepticus is analogous to the multi-organ dysfunction syndrome in severe sepsis. 2011; 76(12):1071-7 Baren J. 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. Boston, MA.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

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. 2011 Jun;153(6):773-9. Epub 2011 Apr 22 Coyne CJ, Le V, Brennan JJ, Castillo EM, Shatsky RA, Ferran K, Brodine S, Vilke GM.

Infectious Diseases 105

Infectious Diseases Administration Sepsis Anaphylaxis 105

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This is true in life-threatening conditions such as sepsis. However, when children do not have features of sepsis, oral antibiotics are equally effective. The take home is that although IV antibiotics are key in sepsis management, oral antibiotics are equally as effective as IV antibiotics for children without critical illness.

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

EMDocs

OCTOBER 5, 2024

8 Workup and Diagnosis Evaluation should be tailored to the patient presentation, but may include studies such as: CBC, CMP, UA, lactate (if concern for sepsis), Cultures (blood, urine, etc.) Therefore, his presentation is most consistent with sepsis due to acute complicated UTI. Microb Drug Resist 2011; 17:267.

EMS 74

EMS Infectious Diseases Sepsis Hospitals 74

Taming the SRU

APRIL 26, 2023

Mil Med 2011. Classification of sepsis, severe sepsis and septic shock: the impact of minor variations in data capture and definition of SIRS criteria. Misdiagnosis of exertional heat stroke and improper medical treatment. Epstein Y, Yanovich R. Heatstroke. N Engl J Med 2019. Gaudio FG, Grissom CK. J Emerg Med 2016.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 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

Mind The Bleep

FEBRUARY 27, 2024

The FEAST study published in 2011 was undertaken across centers in Uganda, Kenya and Tanzania, and randomly allocated children presenting with severe infection and impaired perfusion to groups receiving albumin bolus, saline bolus or no bolus.

Fluid Resuscitation 96

Fluid Resuscitation Hospitals Dehydration Research 96

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

For instance: sepsis, bleeding, dehydration, hypoxia, and mild ACS. Heart 2011; 97 : 838-843 [link] 14. Smith Final Comment: It is uncertain what initiated this patient's instability. Any alteration in physiology can change "compensated" AS to "decompensated" AS. J Am Coll Cardiol. 1985;5(3):711-716. Nishimura RA and Otto CM, et al.

EKG/ECG 52

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 52

The Skeptics' Guide to EM

JUNE 15, 2018

It is like normal saline vs. Ringer’s lactate for fluid resuscitation, steroids vs. no steroids for sepsis, or Coke vs. Pepsi. Dr. Ian Stiell and colleagues published an article in 2011 in Annals of EM looking at variation in recent-onset atrial fibrillation management in Canada and found a lot of variability.

Emergency Department 52

Emergency Department Fluid Resuscitation Hospitals Sepsis 52