EB Medicine

JULY 8, 2019

While it was < 15% in 1990, by 2016 it reached 40%. Nachi: Unfortunately this procedure is associated with a relatively high re-operation rate – one study found 20% of patients required removal or revision. Jeff: Even more shockingly, some series showed a 52% repeat operation rate. Jeff: Well that’s kind worrisome.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Taming the SRU

AUGUST 30, 2023

This finding was not significantly different among operators with different levels of experience, or between adults and children. 2016 Dec;115(6):317-21. 2016 Aug 23;134(8):e113. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. PMID: 29094869. Brigden ML. PMID: 10524488.

Infectious Diseases 90

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 90

Pediatric EM Morsels

NOVEMBER 3, 2023

Both have a range of detection limits, which can be greatly dependent on operator. 2016 Apr; 32(4): 227–231. Worldwide, children <5 years old account for 76% of deaths related to malaria, but these are predominantly in Sub-Saharan Africa (WHO 2022) P. vivax , P. malariae , and the less common P. knowlesi and P. vivax and P.

Seizures 281

Seizures Pediatrics CDC Infectious Diseases 281

EMDocs

DECEMBER 6, 2024

Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. 6 Severe toxicity and shock are typically seen with serum iron concentrations above 500 g/dL and serum iron concentrations above 1000 g/dL are associated with significant mortality. McGraw Hill; 2016.

Poisoning 97

Poisoning Fluid Resuscitation Seizures Resuscitation 97

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 90

Sepsis Fluid Resuscitation Resuscitation Shock 90

Don't Forget the Bubbles

JUNE 30, 2023

Ranulf went white with the shock. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016. These procedures require an experienced operator. These procedures require an experienced operator. These procedures require an experienced operator. Really, in a 14-year-old?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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. Accessed 2/29/2016. Mouth-to-Airway (adjunct).

Emergency Nursing 40

Emergency Nursing EMS Resuscitation Military 40

Don't Forget the Bubbles

MAY 10, 2023

A shocked friend is being ushered out of the way. Then the patient is rapidly moved to the operating theatre. 2016; 24(135): 1-10.DOI: The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre. A teenager lies on the resus trolley. They’re getting CPR.

Emergency Department 91

Emergency Department Resuscitation Documentation/Coding Teamwork 91

ACEP Now

MARCH 14, 2024

Electrical injuries—excluding lightning injuries—account for roughly 10,000 nonfatal shock incidents a year and 500 deaths a year. In the operating room, there was minimal urinary output and the bladder pressures were 35 mmHg under sedation and analgesia. McGraw Hill; 2016. Click to enlarge.) His ECG was unremarkable.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

Don't Forget the Bubbles

JULY 26, 2023

Stredder et al, Archives of Disease in Childhood 2016 we see that 58% were not asked about triggers, 30% were not asked about duration and, importantly for risk stratification, 59% were not asked for a family history of cardiac disease. For anyone approaching a structured ABC would be a priority to establish whether shock was present or not.

EKG/ECG 98

EKG/ECG Hospitals Shock Documentation/Coding 98

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’. Fontan Operation and the Single Ventricle. 2016; 203:138-140. 2016; 10(6):14-15. 2016; 17:2. References Congenital AboulHosn JA et al.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

EB Medicine

JUNE 6, 2019

Nachi: For more information on HIV and its management, check out the February 2016 issue of Emergency Medicine Practice , which covered this and more in depth. Nachi: Moving on to blood pressure: frank hypotension should make you immediately think of a ruptured AAA or septic shock 2/2 an intra abd infection. Jeff: As for the lactate.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

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 Make sure that the patient knows not to operate vehicles or heavy machinery under the influence of drugs. Marijuana actually maintains the highest lifetime use of an illicit drug used within the US. 2015;313(24):2456-2473.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

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. 12 Patients with pelvic fractures and concerning straddle mechanisms should be thoroughly evaluated for genitourinary injuries.

Fractures 63

Fractures Resuscitation Operations EMS 63

Pediatric Emergency Playbook

JANUARY 1, 2017

Neonatal observational scales have been validated in the intensive care and post-operative settings; ED-specific quantitative scales are lacking. CRIES ( Table 1 ) was validated for post-operative patients; to adapt its use for the ED, the most conservative approach is to substitute “preoperative baseline” with normal range for age.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

EB Medicine

JANUARY 2, 2019

Jeff: Perhaps most importantly, no history or physical alone can rule in or out an ectopic pregnancy, for that you’ll need testing and imaging or operative findings. Nachi: And that’s a perfect segue into our next section - diagnostic studies. Jeff: Up first is the urine pregnancy test.

Ultrasounds 40

Ultrasounds Radiology Radiology Infectious Diseases 40

EMDocs

NOVEMBER 13, 2023

in 2016, is a more succinct evaluation for LVO that has been shown to be as sensitive and more specific than the NIHSS. 26 With regards to penetrating neck injuries, particularly those in which the platysma is violated, CTA of the neck has allowed a shift away from mandatory operative exploration of Zone 2 neck wounds (those in the mid-neck).

Stroke 105

Stroke Radiology Radiology Emergency Department 105

Dr. Smith's ECG Blog

MARCH 17, 2025

Nevertheless, the operator performed intravascular ultrasound and saw erupted calcium nodule consistent with plaque erosion. A shocking finding. As always I use the same color conventions for vessels as the rest of my angiography guide. As you can see, the lesion is not very angiographically impressive , more on this below.

EKG/ECG 80

EKG/ECG Documentation/Coding Burns Research 80

Pediatric EM Morsels

MARCH 7, 2025

mg/kg [Nishijima 2016] Poorly studied in renally impaired patients. But what is the drug really approved for, how does it actually work, and what are some of the off-label (for now) uses of TXA that add value to this medication? It is excreted by urine so careful dosing is required if used in kidney disease.

Pediatrics 231

Pediatrics Blood Transfusions Anaphylaxis Military 231