Northwestern EM Blog

JANUARY 24, 2022

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

PHEM Cast

APRIL 10, 2016

The control group received many similar treatments as the ‘intervention’ group (just not full protocolised EGDT) highlighting that with good sepsis care (fluid resuscitation, close monitoring, early appropriate antibiotic administration), mortality can be reduced. 2015 Aug 26;:1–31. 2015 Oct 17;:1–16. 2015 Apr 24;:1–10.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP). She arrives in the emergency department (ED) with decreased level of consciousness and shock.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

PulmCCM

DECEMBER 11, 2024

An excellent review article titled “Sepsis and Septic Shock” was published 4 December 2024 in the New England Journal of Medicine. It’s a wonderful contribution to the literature and well worth reading. But it feels like something important was missed, or misplaced.

Sepsis 45

Sepsis Shock Research Wellness 45

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

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." Committee on Shock. Mouth-to-Airway (adjunct). Advanced Emergency Nursing Blog.

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Pediatric Emergency Playbook

MAY 1, 2017

Also, newborns have a double-whammy administrative load. He will be dehydrated – possibly in shock. 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. He will be irritable. References Benitz WE.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Taming the SRU

MAY 3, 2023

During the admission, she completed a course of broad-spectrum antibiotics and as the underlying shock state improved, she was also weaned off all vasopressor support. However, inhalational administration of epoprostenol requires certain equipment, namely a drug delivery device such as an Aerogen nebulizer (5).

Wellness 52

Wellness Hospitals Shock Outcomes 52

EB Medicine

AUGUST 1, 2018

Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 Also, be aware that there are various formulations of cannabis that allow for different routes of administration. Basically, any way you can imagine, it seems like a route of administration has been explored.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

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!

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

EB Medicine

AUGUST 6, 2019

Jeff: Edoxaban is up next, approved by the FDA in 2015 for similar indications as the other Factor Xa inhibitors. Make sure to get the name, dose, and time of last administration of any DOAC. Jeff: That is simply shocking! It’s also been studied in acute ACS, with increased bleeding and no decrease in ischemic events.

Emergency Department 40

Emergency Department Stroke Wellness Outcomes 40

RebelEM

MAY 15, 2024

Early administration of antibiotics is the only factor known to reduce this mortality. Early administration of antibiotics is the only factor known to reduce this mortality. Volume 21, Issue 6, June 2015, Pages 583-590 Perron T, Emara M, Ahmed S. Febrile neutropenia is a condition conveying high mortality. 2014;14:162.

Infectious Diseases 101

Infectious Diseases Administration Sepsis Anaphylaxis 101

Pediatric Emergency Playbook

JANUARY 1, 2017

CRIES is a 10-point scale, using a physiologic basis similar to APGAR: Crying; Requires increased oxygen administration (distress and breath-holding); Increased vital signs; Expression; and Sleeplessness ( Krechel 1995 ). Once the pain is controlled, less frequent administration of medications, with frequent reassessments, are indicated.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

Intensive Blog

FEBRUARY 9, 2023

The timeframe for administration of charcoal post Amanita phalloides poisoning may be up to 48 hours 9. Vasopressors such as noradrenaline are often required (systemic vasodilation is common in hepatic failure). Disability- treat hypoglycaemia if present. This should be discussed with a toxicologist. Hepatology, 35 (3), 716-721.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Fluid Resuscitation Resuscitation 52

EMDocs

JUNE 3, 2023

4 Patients with pelvic fractures are considered unstable when systolic blood pressure < 90mmHg and heart rate >120bpm, or in those with dyspnea, altered mental status, or skin findings of shock. link] Published June 23, 2015. 12 An AP x-ray of the pelvis should be obtained in the ED for unstable patients. Radiopaedia.org.

Fractures 64

Fractures Resuscitation Operations EMS 64

Taming the SRU

SEPTEMBER 1, 2023

2015) reported a sensitivity of 98.9% 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

EMDocs

NOVEMBER 13, 2023

However, IgE-mediated or not, anaphylactic shock is possible in either case. DOI: 10.1136/neurintsurg-2015-012131 From NLM. (10) Bmj 2015, 351 , h5762. Journal of the American College of Surgeons 2015, 220 (6), 1027-1031. Acta Neurol Scand 2015, 131 (3), 164-168. Stroke 2015, 46 (8), 2368-2400. Kaller, C.

Stroke 105

Stroke Radiology Radiology Emergency Department 105

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. Anemia ; 2015.DOI:10.1155/2015/791498. DOI:10.1155/2015/791498. Plast Reconstr Surg – Glob Open 2015; 3: 83–86. coli and Staphylococcus aureus. References Adewoyin AS. Ware et al.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

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