EMDocs

JUNE 22, 2024

Epub 2014 Jun 30. “Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation.” J Matern Fetal Neonatal Med. 2015 May;28(7):793-8. doi: 10.3109/14767058.2014.932766. PMID: 24974876. Young BK, Florine Magdelijns P, Chervenak JL, Chan M. Amniotic fluid embolism: a reappraisal. J Perinat Med.

EMS 96

EMS Resuscitation Blood Transfusions Seizures 96

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

Don't Forget the Bubbles

JUNE 30, 2023

Importantly, there were no differences between the groups regarding complications, including acute respiratory distress syndrome, multiple organ failure, venous thromboembolism, sepsis, and transfusion-related complications. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016.

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

Taming the SRU

AUGUST 30, 2023

Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear. A 2013 meta-analysis of 30 studies including 3,244 patients published in The Lancet found PCT to have a pooled sensitivity of 77% and specificity of 79% for sepsis in critically ill patients [52]. Epub 2014 Dec 3.

Infectious Diseases 87

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

EMDocs

AUGUST 22, 2023

Capnography has several novel uses in other disease states commonly seen in the ED such as trauma, DKA, sepsis and obstructive lung disease. Correction: Correction to ‘Clinical Policy: Procedural Sedation and Analgesia in the Emergency Department’ [Annals of Emergency Medicine 63 (2014) 247-258.e18]. Ann Emerg Med.

Emergency Department 68

Emergency Department Blood Transfusions Resuscitation Sepsis 68

RebelEM

JANUARY 29, 2024

CHEST 2010. PMID: 19741062 Kucher N et al. Randomized, Controlled Trial of Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Intermediate-Risk Pulmonary Embolism. PMID: 24226805 Piazza G et al.

Stroke 134

Stroke Outcomes Hospitals Administration 134

Don't Forget the Bubbles

JULY 5, 2023

Vaccination: PCV13 (pneumococcal vaccination), meningococcal vaccines, and Hib conjugated vaccines are important to prevent life-threatening sepsis. Sickle cell patients also qualify to receive the annual influenza vaccine, since influenza virus infection predisposes to bacterial pneumonia and sepsis caused by S. Pneumococcal sepsis B.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Taming the SRU

AUGUST 27, 2024

Mortality rates related to bullous skin lesions are typically related to disruption of the skin barrier and include subsequent dehydration, electrolyte imbalances, hypothermia, increased metabolic needs, and secondary infection leading to bacteremia and/or sepsis. Crit Care Med 2014; 42:118. J Am Acad Dermatol 2019; 81:686.

Emergency Department 82

Emergency Department Dehydration Burns Sepsis 82

RebelEM

JANUARY 25, 2023

Emery Med J 2014; 31(3): 248-9. 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. 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 0.27 – 0.83

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

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. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021.

Dehydration 40

Dehydration Fluid Resuscitation Sepsis Resuscitation 40

EMDocs

DECEMBER 18, 2024

2014; 28(5): 401-410. fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold Muncie H, Yasinian Y, Oge L. Outpatient management of alcohol withdrawal syndrome. Am Fam Physician. 2013; 88(9): 589-595. Inpatient management of acute alcohol withdrawal syndrome.

Seizures 88

Seizures Emergency Department Hyperthermia / Hypothermia EMS 88

EMDocs

NOVEMBER 1, 2023

1 , 4 If presenting later in course or with an intra-abdominal perforation, patients are more likely to show signs of sepsis and hemodynamic instability. VBG with lactate 4 – may show low pH with elevated lactate Cardiac biomarkers – to evaluate for cardiac etiology in those presenting with chest pain or type II NSTEMI in those with sepsis.

Operations 67

Operations Radiology Radiology Fluid Resuscitation 67

RebelEM

MARCH 9, 2023

Prerost 2014) In a patient with chronic alcohol use, hallucinations should prompt consideration of acute intoxication, alcoholic hallucinosis, or delirium tremens (DT). Pain / Additional Complaints : Alcohol can weaken the immune system with only moderate use, predisposing individuals to pneumonia, soft tissue infections, and sepsis.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 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

JANUARY 1, 2016

Think meningitis, UTI, or sepsis. Effortless tachypnea may be a sign of acidosis or sepsis. 2014; (38): 1275–1281. ISPAD Clinical Practice Consensus Guidelines 2014. 2014 Sep;15 Suppl 20:154-79. In the stable patient, get an upper GI contrast study. Premature, unwell, and vomiting? Think necrotizing enterocolitis.

Head Injuries 40

Head Injuries Pediatrics Shock Sepsis 40

Pediatric Emergency Playbook

AUGUST 1, 2017

J Pediatr Surg 2014; 49:1619. 2014; 8(5):533-541. 2014; 15(4):859-871. J Pediatr Surg 2005; 40:197. Sulkowski JP, Cooper JN, Congeni A, et al. Single-stage versus multi-stage pull-through for Hirschsprung's disease: practice trends and outcomes in infants. Pyloric Stenosis Aspelund G, Langer JC. Semin Pedaitr Surg. Applegate KE.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Don't Forget the Bubbles

JULY 17, 2023

Evaluating the Impact of the 2017 Dutch Neonatal Early-Onset Sepsis Guideline. 2023 Jun 14;46:8-23 One-year survival and outcomes of infants born at 22 and 23 weeks of gestation in Sweden 2004-2007, 2014-2016 and 2017-2019. Screen time and preschool children: Promoting health and development in a digital world. Paediatr Child Health.

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

Mind The Bleep

SEPTEMBER 17, 2024

Always consider management as per ATLS protocol and SEPSIS 6 if relevant. Management The management is guided by the examination findings which are covered in the respective chapter, this section will delve into the importance of a number of those steps, as well as further long-term care. Ensure the wound has been adequately washed out.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

Northwestern EM Blog

MAY 16, 2022

This is a great summary of the landmark randomized trial published in NEJM in 2014 assessing CT vs two types of US for patients with suspected renal colic in the ED setting. were hospitalizations during f/u period; 26.4% vs. ACR Appropriateness Criteria® acute onset flank pain–suspicion of stone disease. Ultrasound quarterly, 28(3), 227-233.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Northwestern EM Blog

FEBRUARY 14, 2022

This data shows us that angiotensin II can make the blood pressure better but I would never let it distract you from the things we know matter in sepsis resuscitation. Crit Care 2014; 18(5): 534. But what does that mean to us clinically in the ED and ICU? References Chawla LS et al. PMID: 25286986 Russell JA et al.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

Mind The Bleep

MAY 12, 2023

These include infection & sepsis, GI bleeding, dehydration, AKI, alcohol consumption, constipation, and certain medications. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

Don't Forget the Bubbles

JANUARY 10, 2024

3,950 children were recruited between September 2014 to May 2017. These were presented as hazard ratios and included fever at presentation, previous transfusion ever, haemoglobinuria, malaria, sickle cell disease on enrolment, HIV, evidence of sepsis, malnutrition, shock, hypothermia, and dehydration. Do you believe the results?

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

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

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

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9%

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

EMDocs

JUNE 27, 2024

2014 Feb;69(2):144-51. -smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02

Pediatrics 76

Pediatrics Dehydration EMS Hospitals 76

PEMBlog

MARCH 27, 2024

However, sometimes you might hear of siblings or other relatives who had early onset neurologic or GI dysfunction or died early in life, and this can often be attributed to sepsis or sudden infant death syndrome because the symptoms of these overlap with IEMs. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Pediatr Rev. Pediatrics.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

PulmCCM

FEBRUARY 19, 2024

In my anecdotal experience, these phrases have an impressively high positive predictive value for badness (early sepsis, often). Well … no.

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

Don't Forget the Bubbles

JUNE 10, 2024

Systemic Infections : Sepsis and other systemic infections can predispose infants to NEC by compromising the gut barrier and promoting inflammation. Differential diagnoses include septic ileus, and infection causes such as sepsis, meningitis and pneumonia. How do we diagnose necrotising enterocolitis? Gordon, P. Hunter, C.J.,

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

10 The 2014 ACC/AHA guidelines for the Management of Patients with Valvular Heart Disease , referencing this article, gives this recommendation: "CLASS IIb 1. For instance: sepsis, bleeding, dehydration, hypoxia, and mild ACS. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 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. Widespread ST-depression with reciprocal aVR ST-elevation can be cause by: Heart rate related: tachyarrhythmia (e.g.,

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

Taming the SRU

JULY 21, 2023

In infants, this can represent a medical emergency as it can quickly lead to orbital cellulitis and sepsis. Accessed November 10, 2014. HOW DOES TREATMENT BETWEEN INFANTS (< 1 year old) AND ADULTS DIFFER? Hospitalization and emergent ophthalmology consultation are warranted, in addition to IV broad spectrum antibiotics. O’Brien TP.

Emergency Department 86

Emergency Department EMS Burns Wellness 86

Dr. Smith's ECG Blog

FEBRUARY 12, 2023

I went to the chart and found that the patient was a sepsis patient with hypotension and a K of 3.0. A DDENDUM : “My Take” on the ECG diagnosis of RVH appears in the following 4 Figures ( from Grauer K: ECG-2014 e-Pub ). I was reading EKGs on the system before a shift, and saw this one: What do you think? There was no chest pain.

EKG/ECG 40

EKG/ECG Sepsis Ultrasounds 40

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 65

Sepsis Fluid Resuscitation Resuscitation Shock 65

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. No patient subgroup clearly benefited from a higher MAP target (or was harmed by a lower MAP), including patients with sepsis, pre-existing hypertension, or higher organ failure scores. N Engl J Med.

Shock 75

Shock Sepsis Outcomes Hospitals 75