PHEM Cast

APRIL 16, 2018

2012; 73: 102-10. The outcomes from different resuscitative interventions in a haemorrhagic shock model in porcine model: From: Watts et al. Use of CPR in hemorrhagic shock, a dog model. Survival and neurological outcome after OOH TCA in pediatric & adult populations: a systematic review. Critical Care; 2012.

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Resuscitation Shock Ultrasounds CPR 52

EMDocs

NOVEMBER 13, 2024

Older age, recurrent episodes of SBP, hepatorenal syndrome, hepatic encephalopathy, acute kidney injury (AKI), concurrent GI bleeding, and higher MELD scores are predictors of worse outcomes. Management: Patients can rapidly progress to septic shock and multiorgan failure. 2012; 55:1551-1561. coli (50-90% of cases). Hepatology.

Hyperthermia / Hypothermia 79

Hyperthermia / Hypothermia Ultrasounds Shock Hospitals 79

RebelEM

APRIL 29, 2024

Given AHA guidelines recommend early epinephrine administration in cardiac arrest, obtaining access is imperative for resuscitative efforts ( 9) When evaluating over 300,000 out-of-hospital cardiac arrests, a meta-analysis found no significant change in primary outcomes when IV and IO access were compared ( 10 ). 2012 PMID: 21893125.

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Resuscitation Administration Emergency Department Ultrasounds 105

EMDocs

DECEMBER 6, 2024

Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. 6 Severe toxicity and shock are typically seen with serum iron concentrations above 500 g/dL and serum iron concentrations above 1000 g/dL are associated with significant mortality. Published 2012 Jul 1.

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Poisoning Fluid Resuscitation Seizures Resuscitation 76

EMDocs

SEPTEMBER 7, 2024

Clinical features include abdominal or flank pain; ecchymosis to the flank, periumbilical region, proximal thighs, or scrotum; and hemorrhagic shock early in the disease course. Spontaneous retroperitoneal hematoma: etiology, characteristics, management, and outcome. 2012 Aug;43(2):e157-61. angioembolization). J Emerg Med.

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EMS Fluid Resuscitation Resuscitation Radiology 75

EMDocs

JANUARY 11, 2025

2, 8-10, 14 The clinical symptoms range from vague abdominal pain to florid septic shock and peritonitis secondary to bowel perforation. If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. 2012 May-Jun;13(3):283-289. Mathis, K.

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Pediatric Emergency Playbook

APRIL 1, 2016

There are two main reasons for an elevated lactate: the stress state and the shock state. The shock state is due to tissue hypoxia, seen in septic shock. We could use it to track treatment , and see if we can clear the lactate; decreased lactate levels are associated with a better outcome in adults. 2012; 33:1040–1045.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

PHEM Cast

APRIL 10, 2016

This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine; 2012 Jun 27;20(1):1–1. 2012 Jan;30(1):51–6. 2012 Dec 15;186(12):1264–71.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Don't Forget the Bubbles

OCTOBER 10, 2024

The others, such as respiratory rate, heart rate, and decompensated shock, were excluded due to the presumed difficulty for non-healthcare professionals to assess them accurately. Reviewed by: Isabella Davenport Article 2: Does it improve outcomes if you replace the nail in nail bed repair? The assessors scored both groups 5.

Emergency Department 75

Emergency Department Outcomes Research Operations 75

The Skeptics' Guide to EM

DECEMBER 7, 2018

He is unsuccessfully shocked. There was also no increase in survivors with good neurological outcomes with ACLS. JAMA 2012 and Cournoyer et al. Clinical Question: Does the use of epinephrine in cardiac arrest improve survival rates with a favourable neurological outcome? JAMA 2009, Hagihara et al.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

AED Leader

SEPTEMBER 26, 2024

This device can shock the heart back into rhythm. Key takeaways Defibrillators are devices that send electrical shocks to the heart to fix dangerous rhythms. AEDs can save lives outside hospitals by giving quick shocks when someone has a sudden cardiac arrest. It sends an electrical shock to the heart. Hold off the shock!”

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Shock CPR Hospitals EMS 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2012; 43(1):49-51. BMJ 2012; 345:e5521. Does Functional Outcome Improve with Time Postsurgery for Hirschsprung Disease? Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. 2012; 3:247-250. 2012; 92:527-39. 2012; 30:426-431. J Am Coll Surg.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Don't Forget the Bubbles

JULY 26, 2023

For anyone approaching a structured ABC would be a priority to establish whether shock was present or not. Typical features include: HR >220bpm Narrow complex regular tachycardia P waves difficult to identify In this case there is no shock present so we can proceed to the right branch of the ALSG guideline.

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EKG/ECG Hospitals Shock Documentation/Coding 98

Taming the SRU

FEBRUARY 19, 2024

This has been the central question of many research projects with variable outcomes. A recent observational study was performed to pragmatically assess clinically meaningful differences in BP in a diverse critically ill cohort with shock. Damping Damping is essentially the shock absorbers in the pressurized system. Keville, M.

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Shock Resuscitation Ultrasounds Research 59

Downeast Emergency Medicine

APRIL 26, 2021

4] We also know that severe TBI is commonly associated with the development of intracranial hemorrhage where the presence and volume of blood are associated with increased mortality and poor outcomes.[5] Association between prehospital tranexamic acid administration and outcomes of severe traumatic brain injury. JAMA Neurol.

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

RebelEM

JANUARY 25, 2023

J Trauma Acute Care Surg 2012; 73(5): S362-9. Small bowel obstruction: Outcome and cost implications of admitting service. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 PMID: 23114494 Paradis M.

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

Dr. Smith's ECG Blog

OCTOBER 8, 2023

ECG#1 ECG#2 ECG#3 ECG#4 ECG#5 See outcomes of all 5 below, with the Queen of Hearts AI Bot interpretation. The patient died of cardiogenic shock within 24 hours despite mechanical circulatory support. All of the patients presented with chest pain , and they are all in triage. YOU TOO CAN HAVE THE PM Cardio AI BOT!!

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia EKG/ECG Wellness Shock 105

Thinking Critical Care

MAY 18, 2023

In 1983 I was an Englishman abroad, the London anaesthetist who was appointed to be the English anaesthetist on the Shock Team only because the outstanding candidate from Oxford had preferred to take up a job doing muscle relaxant research with Kitz and Katz in the USA. 4] The research agenda at the time was broad.

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Shock Research Sepsis Resuscitation 40

Pediatric Emergency Playbook

JANUARY 1, 2016

Be aware that later stages of malrotation may present as shock – they present in hypovolemic shock due to third-spacing from necrotic bowel and/or septic shock from translocation or perforation. 2012; 43(1): e49–e51. Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema.

Head Injuries 40

Head Injuries Pediatrics Shock Sepsis 40

Dr. Smith's ECG Blog

MAY 8, 2023

Annals of Emergency Medicine 2012; 60(12):766-776. Impella (cardiac output augmentation device) placed for cardiogenic shock Unfortunately, the patient progressed to multiorgan failure with worsening cardiac output despite being maxed on pressors and a balloon pump. He expired 4 days later.

EKG/ECG 52

EKG/ECG Documentation/Coding Outcomes Shock 52

Taming the SRU

AUGUST 30, 2023

Significantly elevated CRP (>122mg/L) and PCT (>0.5ng/mL) levels are predictors of bad outcomes, and are useful for tracking therapy progress, but are not specific enough to rule-in infectious endocarditis [38-39]. Raised inflammatory markers BMJ 2012; 344 :e454 doi:10.1136/bmj.e454 Gabay C, Kushner I. 2012 Jul 23;2(1):32.

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

EB Medicine

MARCH 1, 2019

Consider valvular injury in any patient who appears to be in cardiogenic shock, has hypotension without obvious hemorrhage, or has pulmonary edema. In those with severe injury, you may note refractory hypotension secondary to cardiogenic shock. The latter also recommend ED thoracotomy in those with refractory shock.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

EMDocs

FEBRUARY 12, 2024

First, there can be a poor correlation between venous and arterial gases in states of shock, hemodynamic instability, or extremes of acid-base disturbances, due to poor cardiac output/circulatory failure impairing venous and arterial flow, with associated poor gas exchange as well as hypercapnia and acidemia at the tissue level (8).

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Emergency Department Resuscitation COPD Shock 94

EMDocs

JANUARY 20, 2024

Symptoms of heart failure and cardiogenic shock may develop in more severe cases. Patients with features of shock may require vasopressors, and the decision on the specific drug hinges on the presence or absence of left ventricular outflow tract (LVOT) obstruction.

EMS 74

EMS Fluid Resuscitation Shock EKG/ECG 74

Don't Forget the Bubbles

DECEMBER 11, 2023

This is shocking, but they discovered a staggering dose-response model when they compared these results with medical histories. However, the ACE score was never intended to be used individually but to highlight the links between childhood adversity and lifelong healthcare outcomes and thus provide a measure of risk.

Wellness 104

Wellness Research Outcomes Shock 104

EMDocs

OCTOBER 5, 2024

4 The incidence of ESBL-E identified in bacterial cultures in the United States increased by 53% from 2012 to 2017. Pressors where indicated for septic shock (typically Norepinephrine starting at 0.05 12 Complications Inadequate empiric therapy can lead to treatment delays and worse outcomes. IV fluid resuscitation as needed.

EMS 74

EMS Infectious Diseases Sepsis Hospitals 74

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 According to data from 2012, of the 130 million people reporting illicit drug use within their lifetime, 25% were children between 12 and 17 years of age. million, and cocaine at 1.9

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

EB Medicine

JANUARY 2, 2019

With opportunities to improve outcomes for both the fetus and the mother, I’m confident that this episode will be worth your time. Nachi: For patient who have a threatened miscarriage in the first trimester, there is a 2-fold increased risk of subsequent maternal and fetal adverse outcomes.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

EMDocs

NOVEMBER 13, 2023

2 Outcomes of patients presenting with ischemic stroke who received MRI as initial imaging modality have demonstrated similar outcomes to those with initial CTA, with Kim et al. demonstrating that functional outcome at 3 months did not differ between the CTA and MRI groups (38.5% vs. 38.1%) with a good functional outcome.

Stroke 87

Stroke Radiology Radiology Emergency Department 87

Don't Forget the Bubbles

NOVEMBER 5, 2023

Reviews and opinion articles An update on the role of fluid overload in the prediction of outcome in acute kidney injury. Newborn and Early Infant Outcomes Following Maternal COVID-19 Vaccination During Pregnancy. The effect of myocardial dysfunction on mortality in children with septic shock: a prospective observational study.

Pediatrics 105

Pediatrics Hospitals Infectious Diseases Outcomes 105

EMDocs

JANUARY 20, 2025

Patients were enrolled in these trials if they had signs of shock, with mortality ranging from 18-29%. 13 While there is good data that early antibiotics for patients in septic shock reduce mortality 18-19 the role of early and aggressive volume resuscitation and its impacts on patient-centered outcomes remain unclear.

Dehydration 40

Dehydration Fluid Resuscitation Sepsis Resuscitation 40