Pediatric EM Morsels

NOVEMBER 17, 2023

2016 Feb;30(1):3-11. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. 2022 Apr;29(4):406-414. doi: 10.1111/acem.14431. Anaesthesia. 2019 Sep;74(9):1186-1190. doi: 10.1111/anae.14787. Epub 2019 Jul 16. PMID: 31313280.

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Pediatrics Emergency Department Outcomes Sepsis 183

ALiEM

SEPTEMBER 9, 2024

Patients are at high risk of bacterial spread to the abdomen or retrograde spread up the ventriculoperitoneal shunt leading to peritonitis, peritoneal abscess, ventriculitis, meningitis, or sepsis. 2016 Dec 28;7(Suppl 44):S1150-S1153. Bales J, Morton RP, Airhart N, Flum D, Avellino AM. Surg Neurol Int. doi: 10.4103/2152-7806.196930.

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Sepsis Academics Operations Wellness 60

Taming the SRU

MARCH 30, 2023

Many clinical decision-making tools have been developed and validated in their use to identify and define those who are in sepsis or septic shock, as well as predict a patient’s overall risk of morbidity and mortality, including tools like the SIRS criteria and SOFA score. decreased DSI values). References Vincent JL, De Backer D.

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Shock Outcomes Sepsis Resuscitation 52

Taming the SRU

MAY 5, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. 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. 2016, Andrews, Semler et al. N Engl J Med. N Engl J Med.

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Sensible Medicine

AUGUST 14, 2024

This sort of sepsis would produce many of the common autopsy findings. ”) A 2016 study by Lambert et al in The Journal of Pediatrics shows how variable death investigations can be. Most SIDS babies have congested lungs, and 75% have a history of a recent cold, or an existing cold.

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CDC Sepsis Research Pediatrics 76

EMDocs

JANUARY 23, 2024

An inciting event will typically push them over the edge into BRASH syndrome: Dehydration Hypotension from sepsis or another condition GI illness Dosage increase of a chronic medication (e.g., Published February 15, 2016. The key is a patient who is on an AV nodal blocker and who has some sort of risk factor for renal insufficiency.

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Shock Dehydration Sepsis EKG/ECG 88

The Skeptics' Guide to EM

FEBRUARY 23, 2019

Association Between Early Intravenous Fluids Provided by Paramedics and Subsequent In-Hospital Mortality Among Patients With Sepsis. Association Between Early Intravenous Fluids Provided by Paramedics and Subsequent In-Hospital Mortality Among Patients With Sepsis. Date: February 22nd, 2019 Reference: Lane et al. Reference: Lane et al.

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Sepsis Administration Documentation/Coding Hospitals 52

EMDocs

AUGUST 22, 2023

Capnography has several novel uses in other disease states commonly seen in the ED such as trauma, DKA, sepsis and obstructive lung disease. Published 2016 Jan 29. ETCO 2 correlates with blood pressure, lactate, and base excess in critically ill patients. Further Reading : [link] [link] References: Long B, Koyfman A, Vivirito MA.

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Emergency Department Blood Transfusions Resuscitation Sepsis 68

Taming the SRU

AUGUST 30, 2023

Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear. A 2013 meta-analysis of 30 studies including 3,244 patients published in The Lancet found PCT to have a pooled sensitivity of 77% and specificity of 79% for sepsis in critically ill patients [52]. 2016 Dec;115(6):317-21.

Infectious Diseases 88

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

EMDocs

JUNE 22, 2024

“Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation.” [link] Society for Maternal-Fetal Medicine. Electronic address, p. “Amniotic fluid embolism: diagnosis and management.” ” Am J Obstet Gynecol 215(2): B16-24. link] j.ajog.2016.03.012 2016.03.012 Patel, P.,

EMS 97

EMS Resuscitation Blood Transfusions Seizures 97

Emergency Medicine Ireland

OCTOBER 16, 2023

We’ll start with sepsis. Sepsis is a state of low systemic vascular resistance leading to reduced preload and afterload in the heart. Current Opinion in Critical Care 22 , 260–266 (2016). We’ll start with sepsis. Let’s say you’ve even managed to diagnose it using echo. Tribouilloy, C. &

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Emergency Medicine Ireland

OCTOBER 30, 2023

As such vasopresin exhibits the same ADH effects but this maxes out at very low doses, much lower than what we use in sepsis. A somewhat underwhelming start Second is the VANISH trial by Gordon et al, JAMA 2016. Jama 316 , 509–518 (2016). Vasopressin is an ADH analogue, very simillar in structure with very similar effects.

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Shock Sepsis Wellness Outcomes 52

Don't Forget the Bubbles

JULY 22, 2024

The most recent meta-analysis , published in 2016 (comparing eleven studies from 1986 to 2009), struggled to reach a consensus because the trials were too heterogeneous to make robust conclusions. 2016 Aug;51(8):868–76. 2016 May;67(5):593-601.e3. So, an up-to-date, high-quality meta-analysis iss much needed. Pediatr Pulmonol.

Outcomes 104

Outcomes Research Pediatrics Hospitals 104

PulmCCM

MARCH 11, 2024

Each hospital’s Medical Executive Committee approved the protocol, and data was collected 2016-2018. The trial was funded by NIH and a philanthropic trust. Out of the total sample of 34,239 patients, 44% received palliative care in the automatic group, vs. 16% in the usual care group.

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Hospice Documentation/Coding Administration Hospitals 52

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. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016.

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Resuscitation Operations Sepsis Pediatrics 139

Taming the SRU

FEBRUARY 5, 2024

The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. C., & ESCMID Study Group for Infections of the Brain (ESGIB) (2016). Glennie, L., Gaillemin, O., Wyncoll, D., Kaczmarski, E., Thwaites, G., Davies, N. C., & Solomon, T. Cabellos, C.,

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Infectious Diseases Seizures Ultrasounds Sepsis 97

EMDocs

DECEMBER 18, 2023

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. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician. vs. 0.91), positive predictive value (0.27

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Sepsis Fluid Resuscitation Resuscitation Shock 66

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. Revised National Estimates of Emergency Department Visits for Sepsis in the United States.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

The Skeptics' Guide to EM

SEPTEMBER 30, 2017

In 2016, the American Academy of Pediatrics (AAP) reaffirmed their clinical practice guidelines for the diagnosis and management of UTIs. This two-step process can decrease the rate of catheterization by over 30% without missing UTIs or increasing length of stay in the pediatric emergency department (Lavelle et al Pediatrics 2016 ).

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Pediatrics Emergency Department Sepsis Wellness 52

EB Medicine

JANUARY 10, 2020

This can be the result of hypotension, tachycardia, sepsis, PE, etc. This can be the result of hypotension, tachycardia, sepsis, PE, etc. In-hospital mortality rates are about the same for STEMI and NSTEMI, about 10%. Type 2 MI is the "mismatch" due to an imbalance in myocardial oxygen supply and demand.

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EMDocs

JUNE 27, 2024

2016 Dec;91(12):1185-1190. Epub 2016 Oct 3. -smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 mg/kg, max 0.4 Am J Hematol.

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Pediatrics Dehydration EMS Hospitals 76

RebelEM

JANUARY 29, 2024

Thrombolysis Compared with Heparin for the Initial Treatment of Pulmonary Embolism: A Meta-Analysis of the Randomized Controlled Trials. PMID: 15262836 Sharifi M et al. Pulseless Electrical Activity in Pulmonary Embolism Treated with Thrombolysis (from the “PEAPETT” Study). PMID: 27422214 Wang C et al.

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Stroke Outcomes Hospitals Administration 137

RebelEM

MARCH 9, 2023

Pain / Additional Complaints : Alcohol can weaken the immune system with only moderate use, predisposing individuals to pneumonia, soft tissue infections, and sepsis. 2016 Feb 4;65:242-51. Any report of trauma should prompt evaluation with imaging. Osteopathic Family Physician. 2014 Mar;6(2). Barr T, Helms C, Grant K, Messaoudi I.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

EB Medicine

MARCH 4, 2020

No 1996 AAP guidelines, 2016 ACG guidelines, and 2017 IDSA guidelines all note diarrhea illness but may be vomiting predominant. Specifically, Salmonella, shigella, Campylobacter, and Yersinia 2016 ACG guidelines recommend them for patients with watery diarrhea and moderate to severe illness with fever for at least 72 hours.

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Emergency Department Dehydration Poisoning Allergic Reactions 40

PulmCCM

NOVEMBER 11, 2021

evaluated phenylephrine in 7 critically-ill patients with ‘hyperdynamic’ sepsis [defined as sepsis with CO above 6.0 Yamazaki T, Shimada Y, Taenaka N, Oshumi H, Takezawa J, Yoshiya I: Circulatory responses to afterloading with phenylephrine in hyperdynamic sepsis. Yamazaki et al.

Stroke 40

Stroke Sepsis Administration Wellness 40

RebelEM

FEBRUARY 2, 2023

Sepsis, hyperthyroidism, dehydration, heart failure, ACS, etc). PMID: 36115743 Clinical Question: What is the effectiveness of IV amiodarone vs IV digoxin used as second line therapy in critically ill emergency department patients with atrial fibrillation/flutter where first-line BB use has failed?

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

Don't Forget the Bubbles

JULY 17, 2023

Evaluating the Impact of the 2017 Dutch Neonatal Early-Onset Sepsis Guideline. 2023 Jun 14;46:8-23 One-year survival and outcomes of infants born at 22 and 23 weeks of gestation in Sweden 2004-2007, 2014-2016 and 2017-2019. Screen time and preschool children: Promoting health and development in a digital world. Paediatr Child Health.

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Pediatrics Emergency Department Outcomes Fractures 98

Taming the SRU

JUNE 11, 2023

Enrollment period was from February 2016 to August 2018. Comparing quick sequential organ failure assessment scores to end-tidal carbon dioxide as mor- tality predictors in prehospital patients with suspected sepsis. All patients 18 years and older, with and ESI designation 2-4 were included. Hunter CL, Silvestri S, Ralls G, et al.

Hospitals 87

Hospitals Emergency Department EMS Outcomes 87

Pediatric Emergency Playbook

APRIL 1, 2016

Lactate A sick child with sepsis syndrome? In the adult literature, we know that a lactate level above 4 mmol/L in patients with severe sepsis was associated with the need for critical care. The acute recognition and treatment of sepsis is first and foremost, clinical. The short answer – yes.

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Pediatrics Sepsis Shock Outcomes 52

Pediatric Emergency Playbook

AUGUST 1, 2017

2016; 13:590-600. Eur J Pediatr Surg 2016; 26:192. 2016; 5(1):5-12. Necrotizing Enterocolitis. N Eng J Med. 2011; 364(3):255-264. Niño DF et al. Necrotizing enterocolitis: new insights into pathogenesis and mechanisms. Walsh MC et al. Necrotizing Enterocolitis: A Practitioner’s Perspective. Pediatr Rev. 1988; 9(7):219-226.

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Pediatrics Ultrasounds Resuscitation Sepsis 52

PEMBlog

MARCH 27, 2024

2016 Jan;37(1):3-15; quiz 16-7, 47. However, sometimes you might hear of siblings or other relatives who had early onset neurologic or GI dysfunction or died early in life, and this can often be attributed to sepsis or sudden infant death syndrome because the symptoms of these overlap with IEMs. In: StatPearls [Internet]. Pediatr Rev.

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Pediatrics Seizures Emergency Department Sepsis 59

Taming the SRU

JULY 21, 2023

In infants, this can represent a medical emergency as it can quickly lead to orbital cellulitis and sepsis. 2016 American Academy of Ophthalmology. Anatomy and function of the eye”, KinderKrebsInfo.de ; 21 Nov 2016. Endophthalmitis Highlights”, emDocs; 12 Jan 2016. Conjunctivitis." Jama 310.16 (2013): 1721. and Barry E.

Emergency Department 87

Emergency Department EMS Burns Wellness 87

Don't Forget the Bubbles

JANUARY 10, 2024

These were presented as hazard ratios and included fever at presentation, previous transfusion ever, haemoglobinuria, malaria, sickle cell disease on enrolment, HIV, evidence of sepsis, malnutrition, shock, hypothermia, and dehydration. Sepsis indicators and malaria positivity did not modify the risk. 2016 Jan 7;4(1).

Blood Transfusions 76

Blood Transfusions Outcomes Research Hospitals 76

EB Medicine

JULY 8, 2019

While it was < 15% in 1990, by 2016 it reached 40%. Leakage from the staple line typically presents within the first week, but can present up to 35 days, usually with fevers, tachycardia, abdominal pain, nausea, vomiting sepsis, or peritonitis. Jeff: Well that’s kind worrisome. That’s almost half of the population. million adults!!

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Emergency Department Sepsis Operations Dehydration 40

PulmCCM

DECEMBER 3, 2024

Maintaining a mean arterial pressure (MAP) of 65 mm Hg has been advised for patients with sepsis and other forms of vasodilatory shock. No patient subgroup clearly benefited from a higher MAP target (or was harmed by a lower MAP), including patients with sepsis, pre-existing hypertension, or higher organ failure scores. PMID: 26891677.

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Sepsis Shock Outcomes Hospitals 40

Don't Forget the Bubbles

MARCH 4, 2024

This study retrospectively identified 1,414 children, presenting to 15 UK EDs (2016 -2017), who had been screened for malaria. Reviewed by: John Coveney Article 2: How do we define sepsis in children? International Consensus Criteria for Pediatric Sepsis and Septic Shock. Paediatr Int Child Health. 2024 Jan 11:1-7.

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Hospitals Sepsis Fractures Emergency Department 76

Emergency Medicine Cases

JUNE 13, 2017

The post Episode 97 EM Literature Review 2016 from EMU & Whistler Conferences appeared first on Emergency Medicine Cases.

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EMS Head Injuries Pediatrics Sepsis 52