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

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

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

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 112

EKG/ECG Shock Hospitals Sepsis 112

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

PHEM Cast

APRIL 10, 2016

[link] We hope you enjoyed our sepsis podcast. St Emlyns Induction podcast on Sepsis. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. March 2016.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

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

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 142

Emergency Department Infectious Diseases Pediatrics Sepsis 142

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

Taming the SRU

AUGUST 30, 2023

A 2011 meta-analysis in the journal of Academic Emergency Medicine found ESR, CRP, and PCT were not acutely useful in the diagnosis of septic arthritis due to wildly varying sensitivities and specificities between studies. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear.

Infectious Diseases 81

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 81

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

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.

Outcomes 124

Outcomes Stroke Hospitals Administration 124

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

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 Documentation/Coding Academics 52

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 80

Infectious Diseases Administration Sepsis Anaphylaxis 80

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 Hospitals 52

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

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