EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Some may present with isolated tachycardia while others may present with profound sepsis – tachycardia, hypotension, and fever.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

EMDocs

MAY 11, 2024

Cavernous sinus syndrome (B) usually presents with cranial nerve deficits, diplopia, periorbital cellulitis, and facial swelling that may progress to meningitis or sepsis. Semin Ultrasound CT MR. 2013 Apr;34(2):131-41. Ann Emerg Med. Erratum in: Ann Emerg Med. anatomic region). doi: 10.1053/j.sult.2013.01.004.

Stroke 110

Stroke EMS EKG/ECG Radiology 110

Pediatric Emergency Playbook

APRIL 1, 2016

used BNP in the emergency department to differentiate heart failure from respiratory causes in infants and children with heart failure and those with no past medical history. Lactate A sick child with sepsis syndrome? The acute recognition and treatment of sepsis is first and foremost, clinical. Later, Maher et al.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Broome Docs

AUGUST 2, 2022

Vitamin C in sepsis: STOP IT, we do not LOVE IT Lamontagne F, Masse MH, Menard J, et al; LOVIT Investigators and the Canadian Critical Care Trials Group. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. PMID: 35704292 Bottom line: Sepsis is not treated with vitamins. Am J Emerg Med. N Engl J Med.

Sepsis 52

Sepsis Emergency Department Radiology Radiology 52

ACEP Now

JULY 7, 2024

1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). 2 A study of routine EEG in the ED in 2013 found that five percent of ED patients with altered mental status had nonconvulsive seizures (of whom 75 percent were in nonconvulsive status epilepticus). Ann Emerg Med.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

PEMBlog

OCTOBER 18, 2023

Initially in the emergency department he was generally well-appearing with normal vital signs. rectally, prompting a sepsis workup given his age. Overall picture of an emerging neonatal infectious disease induced by a superantigenic exotoxin mainly produced by methicillin-resistant Staphylococcus aureus.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. WHO - Who Needs an LP in the ED? Clin Infect Dis.

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

Pediatric Emergency Playbook

AUGUST 1, 2017

One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis. 2013; 95(6): 474-477.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

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. Pulmonary embolism in the pediatric emergency department. 2013 Oct;132(4):663-7. 2013; 41:580-637.

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

ACEP Now

OCTOBER 10, 2023

A 76-year-old female presents to the emergency department obtunded with left hemiplegia. External Validity: It is unclear if this data applies to patient you see in your emergency department. link] Published June 30, 2013. Symptoms began just prior to presentation. Her blood pressure (BP) is 195/104 mmHg.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

Northwestern EM Blog

MAY 16, 2022

1 Low-dose non-contrast abdominal CT has become the gold standard for diagnosis as it has become readily available in emergency departments nationwide, with some studies touting sensitivity and specificity of 97% and 95%, respectively.2 The estimated incidence over the past two decades is up to 340 visits per 100,000 individuals.1

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Pediatric Emergency Playbook

JANUARY 1, 2016

Rapid-fire word association for other vomiting emergencies in a neonate : Fever, irritability and vomiting? Think meningitis, UTI, or sepsis. Effortless tachypnea may be a sign of acidosis or sepsis. Accuracy of a screening instrument to identify potential child abuse in emergency departments. J Emerg Med.

Head Injuries 40

Head Injuries Pediatrics Shock Sepsis 40

Don't Forget the Bubbles

JANUARY 10, 2024

Let’s take the humble blood transfusion – used in emergency departments across the globe and playing a key role in critical care. Sepsis indicators and malaria positivity did not modify the risk. Geneva: World Health Organization; 2013. 8% die in hospital, with a further 12% dying in the six months following discharge.

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

Dr. Smith's ECG Blog

AUGUST 9, 2019

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. American heart journal 2010;160:995-1003,e1-8.

EKG/ECG 52

EKG/ECG Shock Emergency Department Wellness 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Widespread ST-depression with reciprocal aVR ST-elevation can be cause by: Heart rate related: tachyarrhythmia (e.g., Am J Med 2019, 132(5):622-630. Miranda DF, Lobo AS, Walsh B, et al.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

RebelEM

MAY 15, 2024

Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. Pathogens ( Gudiol 2013 ) : The pathogens responsible for neutropenic fever have changed over time. Improving the immediate management of neutropenic sepsis in the UK: Lessons from a national audit. Ann Emerg Med.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

EMDocs

OCTOBER 17, 2023

These risk factors are immunosuppression, recent or current antibiotic use, signs of sepsis, symptoms > 5 days, unstable comorbidity, vomiting, CRP > 14 mg/dL or 140 mg/L, or if there are signs of perforation, bleeding, obstruction, or abscess. 2013 May 1;87(9):612-20. 2013 May;15(5):621-6. Am Fam Physician.

Radiology 94

Radiology Radiology Operations Best Practices 94

Don't Forget the Bubbles

JULY 22, 2024

There is an increased risk of pneumonia and sepsis in the 31-90 days after prescription and an increased risk of fractures, GI bleeds and sub-optimal growth. A Randomized Trial of Single-Dose Oral Dexamethasone Versus Multidose Prednisolone for Acute Exacerbations of Asthma in Children Who Attend the Emergency Department.

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department. Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review. This is true in life-threatening conditions such as sepsis. Hibberd, O.;

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

Taming the SRU

JULY 21, 2023

Eye Pathology Now let’s dive back into some common eye disease processes you may see on a typical day in the emergency department. In infants, this can represent a medical emergency as it can quickly lead to orbital cellulitis and sepsis. HOW DOES TREATMENT BETWEEN INFANTS (< 1 year old) AND ADULTS DIFFER?

Emergency Department 88

Emergency Department EMS Burns Wellness 88

Pediatric EM Morsels

FEBRUARY 2, 2024

Internationally Acquired Severe Systemic Infections in Febrile Pediatric Travelers Presenting to the Emergency Department. Pediatr Emerg Care. In the 1950’s travel accounted for 25 million international tourists. However, the destination of travel is also important as helminths have distinct geographical distribution.

Infectious Diseases 164

Infectious Diseases Pediatrics Sepsis Documentation/Coding 164

EMDocs

JUNE 27, 2024

Critical Care Medicine 41(12):p A191, December 2013. 2013 Jan-Mar;16(1):91-5. Epub 2013 Aug 7. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. C or 100.4 mg/kg, max 0.4

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97

Don't Forget the Bubbles

AUGUST 4, 2024

Several case-based variables (older age, mechanism of injury given, location of injury) were associated with diagnostic error, and these variables can be used to close specific skill gaps for clinicians in an emergency department setting to avoid further harm. Neonatal bacterial sepsis. Beaulieu E, Beno S. Paediatr Child Health.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics Burns Sepsis 52

PEMBlog

JANUARY 17, 2024

Camargo, Clinical Trial: Comparative Effectiveness of Cephalexin Plus Trimethoprim-Sulfamethoxazole Versus Cephalexin Alone for Treatment of Uncomplicated Cellulitis: A Randomized Controlled Trial, Clinical Infectious Diseases, Volume 56, Issue 12, 15 June 2013, Pages 1754–1762, [link] Liu C, Bayer A, Cosgrove SE, et al. Bilateral red limbs?

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

EMDocs

JANUARY 16, 2025

Today we cover the Phoenix Sepsis Criteria. years Best performing criteria identified by AUPRC and AUROC 4-organ-system model translated into the Phoenix Sepsis Score had best mortality prediction characteristics AUPRC of 0.23-0.38 Well provide summaries of the evidence to support your decisions at the bedside. but PPV ranges from 25.1-39.5%

Sepsis 95

Sepsis Pediatrics Shock Hospitals 95

EMDocs

JANUARY 20, 2025

Sepsis There has been much controversy over the last two decades around the various nuances of volume resuscitation in ED patients with suspected sepsis, much of which goes beyond the scope of this limited review. In 2013 Richer et al. 2 There is substantial evidence for a few findings regarding volume status assessment.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. These centres have a close relationship with their patients, but this does not mean they may not turn up at your emergency department! Consider sepsis and treat it accordingly. How does your differential diagnosis change?

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Mind The Bleep

SEPTEMBER 17, 2024

Introduction Patients regularly present to the emergency department with animal bites. Always consider management as per ATLS protocol and SEPSIS 6 if relevant. This article aims to help guide you through managing these patients and what factors you might want to consider. Ensure the wound has been adequately washed out.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

EMDocs

MARCH 24, 2025

Those with sepsis should receive broad-spectrum antibiotics based on local hospital antibiograms. HIV Prevention and Treatment: The Evolving Role of the Emergency Department. Ann Emerg Med. He has been having unprotected receptive anal intercourse with two male sexual partners over the past 6 months. 2012;12(4):442-448.

CDC 91

CDC Blood Transfusions Infectious Diseases Sexual Assault 91