RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 133

Stroke Outcomes Hospitals Administration 133

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. JAMA 2018 Guest Skeptics: Jay Loosley is the Superintendent of Education at Middlesex-London Paramedic Service. Background: Sepsis is a serious condition with high morbidity and mortality.

Sepsis 52

Sepsis Administration Documentation/Coding Hospitals 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. 2018, Kuttab, Lykins et al. N Engl J Med.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Taming the SRU

AUGUST 30, 2023

Significantly elevated CRP (>122mg/L) and PCT (>0.5ng/mL) levels are predictors of bad outcomes, and are useful for tracking therapy progress, but are not specific enough to rule-in infectious endocarditis [38-39]. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. They stratified patients according to the ratio of FFP: PRBC received (1:1, 1:2, 1:3 and 1:3+) and performed logistic regression analyses for various outcomes.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. We have a special episode for you this month… We’ve brought Dr. Jeremy Rose, one of the peer reviewers, and a sepsis expert, on with us to talk through the content this month. Jeff : Sepsis chair. Sepsis-3!!

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

The Skeptics' Guide to EM

FEBRUARY 2, 2019

The Lancet 2018. The Lancet 2018. Their workup reveals a multifocal pneumonia with signs of sepsis. The Lancet 2018. Comparison: The lower oxygen target (conservative group) * Outcomes: The authors do not report any one outcome as a primary outcomes, but instead listed morbidity and mortality.

Poisoning 52

Poisoning Administration Hospitals 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. Endovascular and Clinical Outcomes of Vertebrobasilar Intracranial Atherosclerosis-Related Large Vessel Occlusion. 2018 Apr 26;378(17):1573-1582. 2019.00215.

Stroke 107

Stroke EMS EKG/ECG Radiology 107

PulmCCM

JULY 10, 2023

Continuous meropenem infusion for critically ill patients with sepsis Antibiotics have a time-dependent effect on bacteria; maintaining bacteriocidal concentrations of antibiotics should help subdue infections better than intermittent dosing. Mortality was about 30% in each group, and most patients had hospital-acquired sepsis.

Stroke 52

Stroke Sepsis Infectious Diseases Outcomes 52

The Skeptics' Guide to EM

FEBRUARY 24, 2018

[display_podcast] Date: February 14th, 2018 Reference: Venkatesh S et al. NEJM January 2018. display_podcast] Date: February 14th, 2018 Reference: Venkatesh S et al. NEJM January 2018. This looked at hydrocortisone to prevent patients with severe sepsis in developing septic shock. NEJM January 2018.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

Taming the SRU

JUNE 11, 2023

Enrollment period was from February 2016 to August 2018. The primary outcome was in-hospital mortality. The secondary outcome focused on ICU admissions. The tertiary outcome was the relationship between EtCO2 and serum lactate, anion gap and bicarb. The treatment team was blinded by these values. West J Emerg Med.

Hospitals 88

Hospitals Emergency Department EMS Outcomes 88

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. However, even subclinical hypothyroidism with an elevated TSH but normal T4 increases risk of poor outcomes due to effects on cardiac function. 2018; 22(1):215.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

The Skeptics' Guide to EM

FEBRUARY 10, 2018

[display_podcast] Date: February 6th, 2018 Reference: Foster SJ et al. Lancet January 2018 Guest Skeptic: Dr. Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. display_podcast] Date: February 6th, 2018 Reference: Foster SJ et al.

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

RebelEM

FEBRUARY 2, 2023

Small sample size limits the power of the study and increases margin of error A patient-oriented outcome such as mortality was not included Follow-up beyond disposition to evaluate hospitalization recurrences related to atrial fibrillation was not included. Sepsis, hyperthyroidism, dehydration, heart failure, ACS, etc). 2, 2018, pp.

Emergency Department 52

Emergency Department Administration Dehydration EMS 52

Don't Forget the Bubbles

NOVEMBER 15, 2023

One-liner… Understanding how to manage maintenance fluids in critically unwell children best is a basic but important way to improve outcomes. Jasmine, a hypothetical case Jasmine is a 5-year-old girl weighing 18kg admitted to PICU with suspected sepsis. 2018 Apr;44(4):409-417. Epub 2018 Mar 27. Intensive Care Med.

Resuscitation 80

Resuscitation Dehydration Administration Shock 80

The Skeptics' Guide to EM

APRIL 20, 2019

The article was called “A lexicon for gender bias in academia and medicine: Mansplaining is the tip of the iceberg” It was published in the December 2018 edition of the BMJ. Esther Choo et al. Theme music is an important part of the SGEM.

Emergency Nursing 40

Emergency Nursing Sepsis EMS Fractures 40

ACEP Now

MAY 9, 2024

1,2 You’ll also find the story of Sheila Powell, a woman who suffered a pneumothorax during her 2018 Miami BBL and whose 16-year-old daughter worried that in “just a blink of the eye, I could have lost my mom.” These questionable practices led to a rash of bad outcomes.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Can J of Cardiol 2018, 34: 132-145 Here are some other cases: LVH, LBBB, RBBB, and RVH may manifest ST depression without any ischemia! Methods STEMI activations between January 2014 and April 2018 at the University of Arizona Medical Center were identified. Miranda DF, Lobo AS, Walsh B, et al.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

EB Medicine

JUNE 6, 2019

Nachi: And remember that hypothermic patients who are septic have worse outcomes than those who are hyperthermic and septic. However, it can also be due to hypoxia, sepsis, anemia, PE, or metabolic acidosis, so consider all of those also in your differential. was sensitive for 28-day mortality in sepsis.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EB Medicine

SEPTEMBER 1, 2018

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. Nachi: Not only are they out, they actually worsen outcomes, so definitely don’t pursue any of them.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

RebelEM

OCTOBER 31, 2022

Vitamin C can function as an antioxidant and may mitigate endothelial oxidative stress in sepsis. Amrein 2018) A small, single-center, before-and-after study utilized a sepsis cocktail consisting of IV thiamine, hydrocortisone, and vitamin C and discovered a significant decrease in mortality compared to the control group.

Sepsis 52

Sepsis Outcomes Research Shock 52

Don't Forget the Bubbles

AUGUST 21, 2023

Infection/sepsis? What are the long-term outcomes for children with dilated cardiomyopathy? Outcomes at 1 year seem to be influenced by the severity of illness at presentation. Outcomes at 5 years, though, are better amongst those patients admitted to intensive care. Female sex and younger age favour better outcomes.

Pediatrics 98

Pediatrics Outcomes Research Sepsis 98

Don't Forget the Bubbles

JULY 22, 2024

The 2018 PREVIEW trial reported a significant reduction in length of stay (LOS) in children given prednisolone in Australia (24-71 months, mean 41 months) compared to placebo. This is a way to overcome different trial outcomes. This paper’s primary outcome was a change in wheeze severity score (WSS).

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

RebelEM

MAY 15, 2024

Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. 2018 May;26(5):1465-1470. Improving the immediate management of neutropenic sepsis in the UK: Lessons from a national audit. Time to antibiotics and outcomes in cancer patients with febrile neutropenia. Support Care Cancer.

Infectious Diseases 90

Infectious Diseases Administration Sepsis Anaphylaxis 90

EMDocs

OCTOBER 17, 2023

A 2018 risk score incorporates the presence of abdominal guarding, WBC, and CRP. Those with abdominal guarding, WBC over 20,000, and CRP over 25 mg/dL demonstrated a risk of complicated diverticulitis of over 85% (Bolkenstein 2018). 2018 Oct 2;14:1847-1853. 2018 Oct-Nov;53(10-11):1291-1297. Ther Clin Risk Manag.

Radiology 87

Radiology Radiology Operations Best Practices 87

RebelEM

NOVEMBER 11, 2024

Background: Patients with sepsis are routinely treated with empiric broad-spectrum antibiotics while awaiting source identification, as recommended by the surviving sepsis campaign.2 Mortality of Patients With Sepsis Administered Piperacillin-Tazobactam vs Cefepime. address in the article discussed below. JAMA Intern Med.

Sepsis 101

Sepsis Outcomes Administration Shock 101

EMDocs

JUNE 27, 2024

2018 Aug;46(3):144-151. Epub 2018 Oct 17. Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. -smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0

Pediatrics 94

Pediatrics Dehydration EMS Hospitals 94

Don't Forget the Bubbles

FEBRUARY 5, 2024

The study surveyed 2855 Canadian adolescents in 2018 and found that those who skipped breakfast were 2.55 Their main outcome measure was the proportion of pictures inconsistent with current safety recommendations. Role of diagnostic tests for sepsis in children: a review. Half showed a picture of a sleeping baby. Arch Dis Child.

Pediatrics 52

Pediatrics Research Resuscitation Psychiatric 52

Don't Forget the Bubbles

FEBRUARY 24, 2025

Because of this possible diagnosis, they were commenced on a macrolide antibiotic (azithromycin) in addition to treatment for neonatal sepsis +/- meningitis (ceftriaxone and acyclovir). However, our true success is measured by how effectively we share knowledge, foster understanding, and improve patient outcomes. Namachivayam et al.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

PulmCCM

JANUARY 2, 2025

A large proportion have concluded PCT is a safe and effective method to shorten antibiotic courses, including in patients with sepsis. The ADAPT-Sepsis Trial Between 2018 and 2024 at 41 centers in the U.K., Because ADAPT-Sepsis was designed as a noninferiority trial, and the authors chose (arbitrarily) a 5.4%

Sepsis 98

Sepsis Outcomes Stroke Shock 98

Don't Forget the Bubbles

JULY 5, 2023

Furthermore, educating both patients and their families is important in order to achieve good treatment compliance and better clinical outcomes. Vaccination: PCV13 (pneumococcal vaccination), meningococcal vaccines, and Hib conjugated vaccines are important to prevent life-threatening sepsis. 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. 9 In terms of assessing volume status in general, Joseph et al. 11 A study by Stephan et al. Andrews et al. Inwald et al.

Dehydration 73

Dehydration Fluid Resuscitation Sepsis Resuscitation 73

Broome Docs

JANUARY 27, 2025

Correction Rates and Clinical Outcomes in Hospitalized Adults With Severe Hyponatremia: A Systematic Review and Meta-Analysis. doi: 10.1136/emermed-2018-208151. Epub 2018 Oct 25. Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis: The ADAPT-Sepsis Randomized Clinical Trial.

Sepsis 101

Sepsis Anaphylaxis Hospitals Ultrasounds 101

Don't Forget the Bubbles

FEBRUARY 17, 2025

He has received 20ml/kg in 5 to 10ml/kg aliquots in the ED, as his blood pressure keeps dropping, and the ED team is concerned about possible sepsis. By addressing these gaps, we can improve hemodynamic assessments and meaningful outcomes for critically ill pediatric patients. Pediatr Nephrol, 2018. Front Pediatr, 2018.

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78

PulmCCM

FEBRUARY 3, 2025

Patients with oxygen-starved tissues (during strokes, myocardial infarction, sepsis) have been hypothesized (but never shown) to benefit from higher oxygen delivery. and MEGA-ROX (based in Australia), are enrolling many patients with many various illnesses (strokes, cardiac arrest, sepsis, etc.) Can’t we just settle this now?

Sepsis 52

Sepsis Stroke Outcomes Hospitals 52

Don't Forget the Bubbles

JANUARY 13, 2025

Often, these babies are managed as more common neonatal illnesses initially, such as persistent pulmonary hypertension of the newborn, sepsis, or respiratory distress syndrome. Outcome Surgical outcomes in non-obstructive TAPVD are generally good, with a reported mortality of 5% to 10% 3,4. 2018, Elsevier. Copel, et al.,

Operations 59

Operations Outcomes Pediatrics EKG/ECG 59

Emergency Medicine Ireland

MARCH 3, 2025

The catastrophic fall in the first 48hrs of overwhelming sepsis for example would not be consistent with HIT presence of thrombosis. Ann Thorac Surg 105, 650662 (2018). Prevalence and outcomes of patients developing heparin-induced thrombocytopenia during extracorporeal membrane oxygenation. Plos One 17, e0272577 (2022).

Sepsis 52

Sepsis Wellness Outcomes 52