The Skeptics' Guide to EM

FEBRUARY 2, 2019

Their workup reveals a multifocal pneumonia with signs of sepsis. The SGEM Bottom Line was that the routine administration of supplemental oxygen in patients with suspected or confirmed acute myocardial infarction who are not hypoxic does not appear to provide a patient-oriented benefit. Reference: Chu DK et al.

Poisoning 52

Poisoning Administration Hospitals Sepsis 52

Don't Forget the Bubbles

NOVEMBER 15, 2023

Currently, the administration of water for the paediatric population is based on the Holliday-Segar formula (100ml/kg/day for the first 10kg of weight, 50ml/kg/day for the second 10kg of weight and 20ml/kg/day for weight over 20kg). Jasmine, a hypothetical case Jasmine is a 5-year-old girl weighing 18kg admitted to PICU with suspected sepsis.

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

Northwestern EM Blog

JANUARY 24, 2022

Acidosis Acidosis in shock states can present from multiple different sources, including sepsis, hypoxemia, ingestions, hyperlactatemia from hypoperfusion, amongst others. At those levels, bicarbonate administration has not been shown to improve cardiac output, MAP or pressor response. Alternate Shock Not all shock is declared equal.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2015; 18 Gilmore AW et al. 2015 Jun;50(6):923-7 Herliczek TW et al. Plasma levels of lidocaine following nebulized aerosol administration. 2015; 3(5):53-56. Intussusception in Children: Imaging Choices. Semin Roentgenol. 2008; 15-21. Bartocci M et al. J Ultrasound. Am J Emerg Med. 2011; 29:1136-1140.:205-211. Pediatrics.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Mind The Bleep

MAY 12, 2023

Administration of human albumin solution (HAS) in SBP reduces the incidence of renal failure by 72% and mortality by 47%. In those who are grossly obese, it may be better to employ a more cautious approach with regard to albumin administration. The number needed to treat to prevent one death is around 5 in SBP. 2021 Jan;70(1):9-29.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

Pediatric Emergency Playbook

MAY 1, 2017

Also, newborns have a double-whammy administrative load. Check the bilirubin in any neonate you are working up for sepsis. 2015; 135(5):948-53. Newborns are terrible at answering emails. There is a lot of unread unconjugated bilirubin is floating around. The liver and spleen are just not able to keep up. References Benitz WE.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

EB Medicine

SEPTEMBER 1, 2018

As some background, from 2006-2015 there were almost 66,000 reported snake exposures and 31 deaths from snake envenomation in the US. Unfortunately, this myokymia may not respond to antivenom administration and myokymia of the chest well and torso can necessitate intubation in extreme cases. Jeff: What a team! Jeff: What a team!

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

RebelEM

MAY 15, 2024

Early administration of antibiotics is the only factor known to reduce this mortality. Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. Early administration of antibiotics is the only factor known to reduce this mortality. Isolate, but do not wait to initiate treatment.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

Taming the SRU

SEPTEMBER 1, 2023

2015) reported a sensitivity of 98.9% to divert the plane). for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al.,

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

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

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. It may be reasonable to consider IV fluid administration in patients with moderate dehydration or prolonged vomiting.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75