Taming the SRU

MAY 5, 2023

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. Each subsequent one-hour delay in antimicrobial administration increases mortality by 35% in patients with septic shock (Im, Kang et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

Keep your ultrasound handy. 2014) Emergency Care Institute, New South Wales. 2014) Tiny Tip: PRE -eclampsia. Journal of Emergencies, Trauma and Shock, 3(1), 39. 2014) Medscape.com Sullivan, MG (2007) Time Is Critical for Success in Perimortem C-Section ACEP News. Stafford, I. Leibowitz, A. B., & Beilin, Y.

OB/GYN 40

OB/GYN Ultrasounds Emergency Department Resuscitation 40

Pediatric Emergency Playbook

AUGUST 1, 2017

J Pediatr Surg 2014; 49:1619. Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. 2014; 8(5):533-541. J Ultrasound. 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. 2008; 15-21.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Northwestern EM Blog

FEBRUARY 14, 2022

The ATHOS-3 trial in 2017 explored the efficacy of angiotensin II as a vasopressor for severe vasodilatory shock. Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation. were more likely to respond.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

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EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Advanced Emergency Nursing from AENJ

FEBRUARY 29, 2016

Perhaps, not insignificantly, they were accustomed to receiving systematized government-supplied medical and trauma care, with "shock rooms" receiving an influx of victims, as contrasted to those later who opposed "socialized medicine." EM makes a strong push into bedside use of ultrasound sonography. EDNA->ENA.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

RebelEM

JANUARY 25, 2023

2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 Emery Med J 2014; 31(3): 248-9. 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Literature 1. Methods STEMI activations between January 2014 and April 2018 at the University of Arizona Medical Center were identified. A emergent cardiology consult can be helpful for equivocal cases. Left main? 3-vessel disease? Knotts et al.

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EKG/ECG Shock Sepsis Emergency Department 52

Dr. Smith's ECG Blog

OCTOBER 17, 2024

I would do bedside ultrasound to look at the RV, look for B lines as a cause of hypoxia (which would support OMI, and argue against PE), and if any doubt persists, a rapid CT pulmonary angiogram. Figure-2: From Grauer K: ECG Pocket Brain-2014 ePub — regarding "My Take" on defining the ST segment baseline.

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EKG/ECG EMS Shock Ultrasounds 73

Taming the SRU

AUGUST 30, 2023

Notably, lung ultrasound for the diagnosis of bacterial CAP demonstrated exceptional stand-alone diagnostic accuracy in 33 studies including 4,901 adults and children in the emergency department, with a pooled sensitivity of 92% and specificity of 90%. Epub 2014 Dec 3. Epub 2014 Oct 27. Int J Rheum Dis. 2015 Mar;18(3):352-9.

Infectious Diseases 89

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

Pediatric Emergency Playbook

MARCH 1, 2016

On arrival, he was in compensated shock, with tachycardia. In other words, feel free to use ultrasound – especially for things that we in the ED will react to and intervene on – but CT may help to manage the traumatized child non-operatively. 2014 Apr;63(4):460-2. 2014 Aug;49(8):1295-9. He decompensates and needs blood.

Resuscitation 40

Resuscitation Pediatrics Hyperthermia / Hypothermia Operations 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%. Jeff: Next up is ultrasound.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Pediatric Emergency Playbook

JUNE 1, 2017

The infant in shock after a ‘cold’: myocarditis Beware of the poor feeding, tachycardic, ill appearing infant who “has a cold” because everyone else around him has a ‘cold’. 2014; 14(1): 23-227. 2014; 5(4)L631-634. Cardiovasculr Ultrasound. 2014; 12:15. Congenit Heart Dis. 2007; 2:2-11. Aliku TO et al. Circulation.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

EMDocs

DECEMBER 18, 2023

Septic shock is high on the differential diagnosis for this patient’s presentation. 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. What are the most up-to-date guidelines for managing this patient?

Sepsis 93

Sepsis Fluid Resuscitation Resuscitation Shock 93

EMDocs

JULY 15, 2023

A lower extremity radiograph does not reveal any gas formation and an ultrasound of the lower extremity is negative for DVT or cobblestoning, WBC is within normal limits and there are mild elevations in ESR and CRP. 2014 Jul 15;59(2):e10-52. No fungal infections are identified on the feet. What is the most likely diagnosis?

EMS 94

EMS Infectious Diseases Shock Ultrasounds 94

EMDocs

JANUARY 6, 2024

You review his chart and note that he had a heart transplant in 2014 but has not followed up with a cardiologist for at least 3 years. A bedside cardiac ultrasound is performed which shows biventricular failure with a dilated inferior vena cava. His vital signs on arrival include HR: 67 bpm, BP: 101/74 mm Hg, RR: 18 bpm, T: 98.3

EMS 91

EMS Infectious Diseases Shock Emergency Department 91

Pediatric Emergency Playbook

JANUARY 1, 2017

A special note on codeine : Tylenol with codeine (“T3”) has never been a very effective pain medication, as up to 10% of patients lack enzymatic activity to metabolize it into morphine, its active form ( Crews 2014 ). neutropenia) ( Babl 2011 , Dokko 2014 ). Unexplained tachycardia may be the early signs of shock.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

PulmCCM

SEPTEMBER 23, 2021

With the explosion of bedside ultrasound and automated methods to capture LVEF, the ejection fraction will grow in clinical prominence and affect decisions for the acutely-ill. Guarracino F, Ferro B, Morelli A, Bertini P, Baldassarri R, Pinsky MR: Ventriculoarterial decoupling in human septic shock. Critical Care 2014, 18(2):R80.

Stroke 40

Stroke Sepsis Shock Ultrasounds 40

Intensive Blog

FEBRUARY 9, 2023

Other investigations to consider include imaging of the liver with ultrasound and computerised tomography (CT) to assess for any changes to the liver parenchyma or vasculature, such as portal vein thrombosis or Budd Chiari Syndrome (hepatic venous outflow obstruction). 2014, Jan). Disability- treat hypoglycaemia if present. Bellomo, R.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Fluid Resuscitation Resuscitation 52

EMDocs

NOVEMBER 13, 2023

40 The American Academy of Emergency Medicine (AAEM) released a position statement in 2014 advocating for the use of CTA in place of LP when LP cannot be done or has equivocal results. However, IgE-mediated or not, anaphylactic shock is possible in either case. Semin Ultrasound CT MR 2017, 38 (4), 345-356. 4) Madhuripan, N.;

Stroke 105

Stroke Radiology Radiology Emergency Department 105

Mind The Bleep

JUNE 17, 2023

They may present in hypovalaemic shock On examination you may feel a sausage shaped mass in the right side of the abdomen which crosses the midline. Bluman J, 2014) The abdominal pain is colicky / crampy, intermittent and diffuse, the child may struggle to point to a single area of pain. Review of Abdominal Migraine in Children.

Shock 93

Shock Wellness Emergency Department Ultrasounds 93

Mind The Bleep

JUNE 17, 2023

They may present in hypovalaemic shock On examination you may feel a sausage shaped mass in the right side of the abdomen which crosses the midline. Bluman J, 2014) The abdominal pain is colicky / crampy, intermittent and diffuse, the child may struggle to point to a single area of pain. Review of Abdominal Migraine in Children.

Shock 52

Shock Wellness Emergency Department Ultrasounds 52

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. Clin Infect Dis 2011; 52:e18. Stevens DL, Bisno AL, Chambers HF, et al. Fortunately, those are rare.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

EMDocs

JANUARY 20, 2025

Patients were enrolled in these trials if they had signs of shock, with mortality ranging from 18-29%. 13 While there is good data that early antibiotics for patients in septic shock reduce mortality 18-19 the role of early and aggressive volume resuscitation and its impacts on patient-centered outcomes remain unclear. Inwald et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

JULY 5, 2023

Symptoms may be non-specific in the beginning with patients quickly developing septic shock and disseminated intravascular coagulation. The high blood flow velocities through these stenotic segments can be detected using transcranial doppler ultrasound (TCD). 2014; 349–356. coli and Staphylococcus aureus. Macharia AW et al.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

RebelEM

FEBRUARY 7, 2024

Philadelphia, PA: Elsevier Saunders; 2014:2331-2350. Philadelphia, PA: Elsevier Saunders; 2014: 2282-2299. Triple antibiotic coverage is recommended. Gorgas, D. “Infections related to pregnancy.” ” Emerg Med Clin North Am 26 (2): 345-366, viii. PMID: 18406978 Houry, D and B. Acute Complications of Pregnancy.

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Sepsis Shock Hospitals Ultrasounds 102