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. Endovascular and Clinical Outcomes of Vertebrobasilar Intracranial Atherosclerosis-Related Large Vessel Occlusion.

Stroke 89

Stroke EMS EKG/ECG Radiology 89

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

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

Taming the SRU

MARCH 30, 2023

Diastolic shock index and clinical outcomes in patients with septic shock. The pathologic vasodilation observed in sepsis is thought to result from failure of the vascular smooth muscle to constrict appropriately, leading to hypotension as well as tissue hypoperfusion (2). Ospina-Tascón GA, Teboul J-L, Hernandez G, et al.

Shock 52

Shock Outcomes Sepsis Resuscitation 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]. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear.

Infectious Diseases 86

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 86

EB Medicine

JULY 8, 2019

Jeff: Do note, however that 2013 guidelines do not recommend one procedure over another and leave that decision up to local surgical expertise, patient specific risk factors, and treatment goals. 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

Pediatric Emergency Playbook

JANUARY 1, 2016

Think meningitis, UTI, or sepsis. Effortless tachypnea may be a sign of acidosis or sepsis. Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. 2013; (34)7: 307-321. In the stable patient, get an upper GI contrast study. Premature, unwell, and vomiting?

Head Injuries 40

Head Injuries Pediatrics Shock Sepsis 40

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

ST elevation (STE) in lead augmented vector right (aVR), coexistent with multilead ST depression, was endorsed as a sign of acute occlusion of the left main or proximal left anterior descending coronary artery in the 2013 STEMI guidelines. BOTTOM Line from Today’s Case: As per Drs.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Pediatric status epilepticus is analogous to the multi-organ dysfunction syndrome in severe sepsis. 2013; 54 Suppl 7:23-34 Chin RFM et al., Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study. In other words – time is brain. Or… is it something else as well?

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Don't Forget the Bubbles

JULY 22, 2024

Randomised controlled trials addressing the benefit of steroids in preschool wheeze have compared different cohorts, used different trial designs and measured different outcomes. This is a way to overcome different trial outcomes. This paper’s primary outcome was a change in wheeze severity score (WSS). What does this mean?

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

RebelEM

JANUARY 25, 2023

Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 67

Sepsis Shock Resuscitation Fluid Resuscitation 67

RebelEM

AUGUST 12, 2024

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

Outcomes 74

Outcomes Hospitals Operations Shock 74

Don't Forget the Bubbles

AUGUST 4, 2024

They used servo-controlled therapeutic hypothermia (versus passive hypothermia) and found no major difference in outcome. Neonatal bacterial sepsis. The Role of Family Support in Moderating Mental Health Outcomes for LGBTQ+ Youth in Primary Care. More studies on this topic will surely follow. Beaulieu E, Beno S. JAMA Pediatr.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics Burns Sepsis 52

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 133

Stroke Outcomes Hospitals Administration 133

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? However, with ultrasonography becoming more prevalent in EDs, it may be possible that initial imaging may avoid this radiation risk and still have similar outcomes for patients. Would you be satisfied with only US and no follow-up CT?

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Pediatric Emergency Playbook

APRIL 1, 2016

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. The acute recognition and treatment of sepsis is first and foremost, clinical. The short answer – yes.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Pediatric Emergency Playbook

AUGUST 1, 2017

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. 2013; 95(6): 474-477. 2013; 48:1789-1793. 2013; 44(1):53-57. J Med Genet 2008; 45:1. Arshad A, Powell C, Tighe MP.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

EMDocs

OCTOBER 17, 2023

However, no included studies compared patient health outcomes between CT-guided care and care without the use of routine CT for suspected diverticulitis. 2013 May 1;87(9):612-20. 2013 May;15(5):621-6. Clinicians should err on the side of imaging in patients with predictors of progression to complicated diverticulitis.

Radiology 68

Radiology Radiology Operations Best Practices 68

EMDocs

OCTOBER 23, 2023

This may also predispose a patient to sepsis, peritonitis, or bowel infarction, which need to be recognized quickly. 2013 Mar; 121 (3): 654-673. Morbidity outcomes of 78,577 hysterectomies for benign reasons over 23 years. A patient may experience pelvic pressure or a bulge in the vagina if bowel evisceration occurs (1,7).

OB/GYN 67

OB/GYN Operations EMS Ultrasounds 67

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. Support Care Cancer.

Infectious Diseases 96

Infectious Diseases Administration Sepsis Anaphylaxis 96

Dr. Smith's ECG Blog

AUGUST 9, 2019

Chris' comments/questions: "Every "ST elevation in aVR" case I've ever seen has been triple vessel, insufficiency, or demand/global subendocardial ischemia secondary to some underlying sepsis/increased metabolic demand." "My ST Elevation Myocardial Infarction Due To LEFT Main Culprit Lesions: Percutaneous Coronary Intervention Outcomes.

EKG/ECG 52

EKG/ECG Shock Emergency Department Wellness 52