Remove 2012 Remove Sepsis Remove Wellness
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Clinical Conundrum: Should We Always Treat Fever in Patients with Sepsis?

RebelEM

Bottom Line Up Top: There doesnt appear to be a morbidity or mortality benefit to treating fever in sepsis and fever may have a protective effect. You order antibiotics, an initial fluid bolus as well as blood cultures. Am J Resp Crit Care Med 2012; 185(10): 1088-1095. Only treat fever if it causes the patient distress.

Sepsis 72
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emDOCs Podcast – Episode 89: Antibiotics for Uncomplicated Diverticulitis

EMDocs

Antibiotics are recommended for those with complicated diverticulitis, as well as surgical specialist consult if necessary (e.g., 2012 Apr;99(4):532-9. Included patients had confirmed uncomplicated diverticulitis but no immunosuppression, peritonitis, sepsis. Patients with sepsis and immunocompromise were not included.

Sepsis 88
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Diastolic Shock Index: A clinically relevant predictor of poor outcome in septic shock?

Taming the SRU

10.1186/s13613-020-00658-8 P: A total of 761 patients from two separate cohorts found to have septic shock I: Diastolic shock index C: Comparison to a variety of well adopted markers of morbidity and mortality, including systolic shock index, SOFA score, APACHE II score, lactate, etc. Ann Intensive Care 2020;10(1):41. decreased DSI values).

Shock 52
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EM@3AM: Stercoral Colitis

EMDocs

Well keep it short, while you keep that EM brain sharp. Clinical exam: 2, 3, 9 Abdominal distension and tenderness Nausea and vomiting Stool present in the rectal vault Peritonitis may be accompanied by hemodynamic instability in the case of sepsis. May still be passing small amounts of stool and flatus.

EMS 72
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EM@3AM: Endometritis

EMDocs

2012 May;27(5):1368-74. Epub 2012 Mar 14. Incidence, treatment and outcome of peripartum sepsis. Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis. Hum Reprod. doi: 10.1093/humrep/des076. PMID: 22419745.

OB/GYN 64
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Big Labs, Little People

Pediatric Emergency Playbook

Brain natriuretic peptide (BNP) In adults, we typically think of a BNP Luckily, we have data in children with congenital heart disease as well. Lactate A sick child with sepsis syndrome? In the adult literature, we know that a lactate level above 4 mmol/L in patients with severe sepsis was associated with the need for critical care.

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The Pediatric Surgical Abdomen

Pediatric Emergency Playbook

2012; 43(1):49-51. BMJ 2012; 345:e5521. 2012; 3:247-250. 2012; 92:527-39. Intestinal Malrotation – Not Just the Pediatric Surgeon’s Problem. J Am Coll Surg. 2004; 199(4):628-635. Lee HC et al. Intestinal Malrotation and Catastrophic Volvulus in Infancy. J Emerg Med. Martin V, Shaw-Smith C. Pediatr Surg Int. Dias SC et al.