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

EM Curious

JULY 29, 2015

S-E-P-S-I-S A SEPSIS SMACC-BACK [PODCAST]: If you were at SMACC 2015 you may have been confused after the sepsis expert panel discussion. If you weren't there, you still should listen to this discussion on sepsis 3.0. Read on here.

Sepsis 52

Sepsis EMS Emergency Department Ultrasounds 52

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. Complications of acute gallbladder perforation include localized peritonitis, hepatic, subhepatic, or pelvic abscess formation, pneumonia, pancreatitis, acute renal failure, and sepsis (7). 2015 Oct;16(5):509-12.

Ultrasounds 78

Ultrasounds Sepsis Radiology Radiology 78

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

Guest Skeptic: Dr. Natalie May trained as an emergency physician with subspecialty paediatric emergency medicine in the UK and worked in Manchester and Oxford before moving to Australia in 2015 to work for Sydney […] The post SGEM#190: Wee are the Champions of Pediatric Urine Samples first appeared on The Skeptics Guide to Emergency Medicine.

Pediatrics 52

Pediatrics Emergency Department Sepsis Wellness 52

EB Medicine

SEPTEMBER 1, 2018

Jeff: Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the September 2018 issue of Emergency Medicine Practice - Emergency Department Management of North American Snake envenomations.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Case: You’re working a shift in a rural emergency department when a 68-year-old man presents with a two-day course of worsening cough, shortness of breath, and fever. Their workup reveals a multifocal pneumonia with signs of sepsis. This study expands upon that investigation to patients with other conditions as well.

Poisoning 52

Poisoning Administration Hospitals Outcomes 52

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). Broadstock is a Clinical Instructor and Ultrasound Fellow in Emergency Medicine at the University of Cincinnati and an Assistant Editor of TamingtheSRU. WHO - Who Needs an LP in the ED? Cabellos, C.,

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Pain / Additional Complaints : Alcohol can weaken the immune system with only moderate use, predisposing individuals to pneumonia, soft tissue infections, and sepsis. Annals of Emergency Medicine.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

Don't Forget the Bubbles

JANUARY 10, 2024

Let’s take the humble blood transfusion – used in emergency departments across the globe and playing a key role in critical care. Sepsis indicators and malaria positivity did not modify the risk. Published 2015 Feb 2. 8% die in hospital, with a further 12% dying in the six months following discharge. 1993;55(1-2):47-51.

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

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. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this. c) Or, do both?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. Epub 2015 Aug 22.

Pediatrics 183

Pediatrics Emergency Department Outcomes Sepsis 183

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. They recommended synovial fluid analysis as essential to the diagnosis [30].

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

Taming the SRU

APRIL 26, 2023

J Intensive Care Med 2015. Classification of sepsis, severe sepsis and septic shock: the impact of minor variations in data capture and definition of SIRS criteria. Evidence-Based Heatstroke Management in the Emergency Department. West J Emerg Med 2021. References Chiha M, Samarasinghe S, Kabaker AS.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 52

EMDocs

MAY 11, 2024

Cavernous sinus syndrome (B) usually presents with cranial nerve deficits, diplopia, periorbital cellulitis, and facial swelling that may progress to meningitis or sepsis. Clinical Policy: Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department. Ann Emerg Med.

Stroke 101

Stroke EMS EKG/ECG Radiology 101

EB Medicine

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. Thankfully, fatalities are declining, with just 565 in 2015. Jeff: You’re right. Jeff: You’re right.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

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. Hypothyroidism and Adrenal Insufficiency in Sepsis and Hemorrhagic Shock. Emergency Medicine Clinics of North America. Curr Opin Crit Care. 2008;14:379-83.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Some may present with isolated tachycardia while others may present with profound sepsis – tachycardia, hypotension, and fever.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Pediatric Emergency Playbook

AUGUST 1, 2017

One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis. 2015; 18 Gilmore AW et al.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

Mind The Bleep

SEPTEMBER 17, 2024

Introduction Patients regularly present to the emergency department with animal bites. Always consider management as per ATLS protocol and SEPSIS 6 if relevant. This article aims to help guide you through managing these patients and what factors you might want to consider. Ensure the wound has been adequately washed out.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

EMDocs

JULY 15, 2023

sepsis), immunocompromised patients, IV drug users, patients with prosthetic heart valves or any intravascular device Clinical features may not abe enough to differentiate erysipelas from cellulitis, and in such cases the treatment should be targeted towards cellulitis Labs No laboratory evaluation is required for the diagnosis of erysipelas.

EMS 76

EMS Infectious Diseases Shock Ultrasounds 76

EMDocs

JUNE 27, 2024

2015 May;169(4):492-505. Epub 2015 Mar 30. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02 Am J Hematol.

Pediatrics 88

Pediatrics Dehydration EMS Hospitals 88

EB Medicine

JUNE 6, 2019

Jeff: Abdominal pain is the one of most frequent complaint in US emergency departments, representing 8% of all adult ED visits, with admission rates for all patients with abdominal pain ranging between 18-42% and reaching as high as 60% for the elderly. was sensitive for 28-day mortality in sepsis. In one study, a SI > 0.7

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

The Skeptics' Guide to EM

JUNE 15, 2018

Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.

Emergency Department 52

Emergency Department Fluid Resuscitation Hospitals Sepsis 52

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department. Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review. This is true in life-threatening conditions such as sepsis. Hibberd, O.;

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

RebelEM

MAY 15, 2024

Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. Comparison of the MASCC and CISNE scores for identifying low-risk neutropenic fever patients: analysis of data from three emergency departments of cancer centers in three continents. Ann Emerg Med. Support Care Cancer.

Infectious Diseases 86

Infectious Diseases Administration Sepsis Anaphylaxis 86

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. These centres have a close relationship with their patients, but this does not mean they may not turn up at your emergency department! Consider sepsis and treat it accordingly. How does your differential diagnosis change?

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

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 81

Sepsis Pediatrics Shock Hospitals 81

PulmCCM

JANUARY 27, 2025

.” —Palliative Care for Patients With Cancer: ASCO Guideline Update, July 1 2024 Every day, patients with advanced metastatic cancer arrive in emergency departments and ICUs with the terrible complications that signal they are in the final days of their lives. ASH education program, 2015 Shih HH, Chang HJ, Huang TW.

Hospice 89

Hospice Outcomes Sepsis Emergency Department 89

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. Volume status Assessing volume status, especially in critically ill patients, can be challenging. Andrews et al.

Dehydration 69

Dehydration Fluid Resuscitation Sepsis Resuscitation 69