Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016. They looked at 119 adult patients from an (unspecified) number of trauma centres.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Taming the SRU

MAY 5, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. 2014, Hjortrup, Haase et al. N Engl J Med.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. We have a special episode for you this month… We’ve brought Dr. Jeremy Rose, one of the peer reviewers, and a sepsis expert, on with us to talk through the content this month. Jeff : Sepsis chair. Sepsis-3!!

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

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 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

RebelEM

JANUARY 25, 2023

Emery Med J 2014; 31(3): 248-9. Small bowel obstruction: Outcome and cost implications of admitting service. 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.

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

Don't Forget the Bubbles

JANUARY 10, 2024

Some wonder if giving blood to children with a haemoglobin <6g/dl will improve outcomes. 3,950 children were recruited between September 2014 to May 2017. Outcomes Primary outcome Mortality at 28 days after randomisation. The authors chose a patient-centred, primary outcome in keeping with their pragmatic design.

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

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

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

Northwestern EM Blog

FEBRUARY 14, 2022

The primary outcome of the study was the response in MAP three hours after the start of angiotensin II infusion. It showed improvement in blood pressure which is a clinically important parameter but not a patient-oriented outcome. However, one limitation of the study was that it was underpowered to demonstrate a mortality difference.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 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. J Pediatr Surg 2014; 49:1619. 2014; 8(5):533-541. 2014; 15(4):859-871. J Med Genet 2008; 45:1. Hirschsprung's disease.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Pediatric Emergency Playbook

JANUARY 1, 2016

Think meningitis, UTI, or sepsis. Effortless tachypnea may be a sign of acidosis or sepsis. 2014; (38): 1275–1281. Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema. ISPAD Clinical Practice Consensus Guidelines 2014. 2014 Sep;15 Suppl 20:154-79.

Head Injuries 40

Head Injuries Pediatrics Shock Sepsis 40

Pediatric Education

AUGUST 20, 2023

per 100,000 hospitalizations in 2014. In the US study, the most common underlying PLA risk factor was liver transplant with biliary disease, malignancy and intrabdominal pathology and severe sepsis being other common factors in this population. Mortality rate was 0.8%. This study specific excluded patients with ALA or candidemia. .”

Pediatrics 40

Pediatrics Infectious Diseases Wellness Sepsis 40

Don't Forget the Bubbles

JUNE 10, 2024

Despite advancements in neonatal care, NEC remains a significant concern due to its association with adverse outcomes, including prolonged hospitalisation, the need for surgical intervention, and increased mortality rates. Differential diagnoses include septic ileus, and infection causes such as sepsis, meningitis and pneumonia.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

EB Medicine

JULY 8, 2019

Jeff: A 2014 study even showed an up to 80% reduction in the likelihood of developing DM2 postoperatively at the 7-year mark. overall, these surgeries are relatively safe with one 2014 review publishing a 10-17% overall complication rate and a perioperative 30 day mortality of less than 1%. Nachi: So we have a lot to cover!

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Methods STEMI activations between January 2014 and April 2018 at the University of Arizona Medical Center were identified. As a result — cardiac cath was not performed — since results of a cath would not have altered the unfortunate outcome. BOTTOM Line from Today’s Case: As per Drs.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

EMDocs

DECEMBER 18, 2023

Introduction Sepsis and septic shock are life-threatening conditions characterized by severe systemic inflammation and organ dysfunction due to a dysregulated host response to infection. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician. vs. 0.91), positive predictive value (0.27

Sepsis 91

Sepsis Fluid Resuscitation Resuscitation Shock 91

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. 2014 Aug 21;124(8):1251-8; quiz 1378. doi: 10.1182/blood-2014-02-482612. Epub 2014 May 28. Support Care Cancer.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

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. 2014 Feb;46(2):119-24. 2014 Apr;80(4):391-5. Clinicians should err on the side of imaging in patients with predictors of progression to complicated diverticulitis.

Radiology 94

Radiology Radiology Operations Best Practices 94

RebelEM

NOVEMBER 11, 2024

Background: Patients with sepsis are routinely treated with empiric broad-spectrum antibiotics while awaiting source identification, as recommended by the surviving sepsis campaign.2 Mortality of Patients With Sepsis Administered Piperacillin-Tazobactam vs Cefepime. address in the article discussed below. JAMA Intern Med.

Sepsis 113

Sepsis Outcomes Administration Shock 113

EMDocs

OCTOBER 23, 2023

This may also predispose a patient to sepsis, peritonitis, or bowel infarction, which need to be recognized quickly. Morbidity outcomes of 78,577 hysterectomies for benign reasons over 23 years. March 2014. It may present with vaginal bleeding (the most common presenting symptom) (3), or watery vaginal discharge (2,6).

OB/GYN 93

OB/GYN Operations EMS Ultrasounds 93

EMDocs

JUNE 27, 2024

2014 Feb;69(2):144-51. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Factors associated with adverse outcome among children with sickle cell disease admitted to the pediatric intensive care unit: an observational cohort.

Pediatrics 97

Pediatrics Dehydration EMS Hospitals 97

Don't Forget the Bubbles

JULY 17, 2023

Evaluating the Impact of the 2017 Dutch Neonatal Early-Onset Sepsis Guideline. Clinical Outcomes of COVID-19 in Newborns and Infants: A Multicenter Experience of 576 Cases. 2023 Jun Oral food challenge outcomes in children and adolescents in a tertiary centre: A 5-year experience. Paediatr Child Health. Van Rossem EJD, et al.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

PEMBlog

JANUARY 17, 2024

Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 2014; 59:e10. Full blown sepsis and toxic shock syndrome. You’re concerned about SIRS or sepsis. Clin Infect Dis 2011; 52:e18. 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

Don't Forget the Bubbles

JULY 5, 2023

Furthermore, educating both patients and their families is important in order to achieve good treatment compliance and better clinical outcomes. Vaccination: PCV13 (pneumococcal vaccination), meningococcal vaccines, and Hib conjugated vaccines are important to prevent life-threatening sepsis. Pneumococcal sepsis B.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

PulmCCM

DECEMBER 3, 2024

Maintaining a mean arterial pressure (MAP) of 65 mm Hg has been advised for patients with sepsis and other forms of vasodilatory shock. More than a dozen randomized controlled trials (RCTs) have sought to identify whether higher or lower MAP targets produce better outcomes in critically ill patients with shock. Epub 2014 Mar 18.

Shock 75

Shock Sepsis Outcomes Hospitals 75

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. 9 In terms of assessing volume status in general, Joseph et al. 11 A study by Stephan et al. Andrews et al. Inwald et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

JANUARY 13, 2025

Often, these babies are managed as more common neonatal illnesses initially, such as persistent pulmonary hypertension of the newborn, sepsis, or respiratory distress syndrome. Outcome Surgical outcomes in non-obstructive TAPVD are generally good, with a reported mortality of 5% to 10% 3,4. 2014, Mosby: Philadelphia.

Operations 59

Operations Outcomes Pediatrics EKG/ECG 59

Mind The Bleep

JANUARY 24, 2025

Blood cultures in cases of suspected sepsis. Documentation and Communication Maintain meticulous records of assessments, interventions, and outcomes. By implementing structured assessment tools and preventive measures, healthcare providers can significantly improve patient outcomes and quality of life. Clinical guideline CG179.

Sepsis 52

Sepsis Documentation/Coding Outcomes Ultrasounds 52

Don't Forget the Bubbles

SEPTEMBER 23, 2024

Consider sepsis and treat it accordingly. Consider CMV, EBV and BK-polyoma virus infections: Patients are often on prophylaxis for a variable length of time, with differing outcomes. Obesity: Obesity, whether before or after transplant, is linked to worse outcomes. CAKUT, catheterization requirement). and Hirsch, H.H.,

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Taming the SRU

FEBRUARY 3, 2025

Academic Press; 2014:39-64. InHospital Outcomes of Tumor Lysis Syndrome: A PopulationBased Study Using the National Inpatient Sample. paclitaxel, doxorubicin, cisplatin) high-risk monoclonal antibody treatments (i.e. In: Finkel KW, Howard SC, eds. Renal Disease in Cancer Patients. doi:10.1016/B978-0-12-415948-8.00004-0 2.

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56