Taming the SRU

MARCH 30, 2023

Background Early recognition and resuscitation of patients in septic shock are critical skills for an emergency medicine physician. The pathologic vasodilation observed in sepsis is thought to result from failure of the vascular smooth muscle to constrict appropriately, leading to hypotension as well as tissue hypoperfusion (2).

Shock 52

Shock Outcomes Sepsis Resuscitation 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. 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.

Emergency Department 68

Emergency Department Blood Transfusions Resuscitation Sepsis 68

Northwestern EM Blog

JANUARY 24, 2022

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. There is a subset of patients who, despite aggressive conventional resuscitation, have an inadequate hemodynamic response and develop refractory shock. 2010; 36: 2019-2029.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Date: January 28th, 2019 Reference: Chu DK et al. Date: January 28th, 2019 Reference: Chu DK et al. Their workup reveals a multifocal pneumonia with signs of sepsis. Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis.

Administration 52

Administration Poisoning Hospitals Outcomes 52

The Skeptics' Guide to EM

JANUARY 25, 2020

NEJM February 2019 Guest Skeptic: Andrew Merelman is a critical care paramedic and second year medical student at Rocky Vista University in Colorado. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults.

EMS 40

EMS Airway Management Administration Resuscitation 40

EMDocs

OCTOBER 8, 2024

The full differential diagnosis of sinus tachycardia in isolation is extensive ranging from benign etiologies such as anxiety to severely life threatening etiologies such as sepsis. Additional resuscitation Have we addressed all potential sources of shock for the patient in front of us? IVF Have we rehydrated as clinically indicated?

Shock 95

Shock Emergency Department Pediatrics EKG/ECG 95

EMDocs

JUNE 27, 2024

2019 Jan 24;14:263-292. -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 4 mg per dose q20-30min) or hydromorphone (0.01-0.02

Pediatrics 75

Pediatrics Dehydration EMS Hospitals 75

RebelEM

MARCH 27, 2023

2019 Aug; PMID: 30954692 Clinical Question: What is the impact of system factors in the implementation of standard-of-care LPV in critically ill ED patients admitted to the ICU? 4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. Paper: Owyang CG, et al. J Crit Care.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

RebelEM

FEBRUARY 2, 2023

Based on 2019 American Heart Association (AHA) guidelines, amiodarone and digoxin have been suggested as alternative options in controlling ventricular rate refractory to first-line BBs and non-DHP CCBs. Sepsis, hyperthyroidism, dehydration, heart failure, ACS, etc). PMID: 36115743 Panchal, Ashish R., Circulation , 5 Nov.

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Am J Med 2019, 132(5):622-630. Now there is a paper published in 2019 that proves the point beyond doubt, though makes it clear that this pattern is associated with very high mortality. American Journal of Medicine 132(5):622-630; May 2019. Knotts RJ, Wilson JM, Kim E, Huang HD, Birnbaum Y. J Electrocardiol 2013;46:240-8 2.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

Mind The Bleep

MAY 12, 2023

9 There is no role for Tranexamic acid in upper GI bleeding and its use is harmful to patients 11 Escalate to a senior early for consideration of a higher level of care Refer for early endoscopy after resuscitation with haemodynamic stability. 12 References The British Liver Trust (2019). On Day 3 (i.e. On Day 3 (i.e.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

EM Updates

JUNE 15, 2021

Any patient requiring high acuity care not thought to be infected with coronavirus was cared for in a different area that had previously been a low acuity zone, but which was subsequently equipped for resuscitation. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19).

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

EB Medicine

JULY 8, 2019

I’m Jeff Nusbaum and I’m back with Nachi Gupta for the 30 th episode of EMplify and the first Post-Ponte Vedra Episode of 2019. 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.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Don't Forget the Bubbles

NOVEMBER 1, 2023

This is not always feasible in an acute resuscitation scenario. This retrospective observational cohort study looked at whether lactate can be used to predict the need for acute resuscitation in paediatric emergency department (PED) patients. In children who did not need acute resuscitation, the 95th percentile of lactate was 3.2

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

Taming the SRU

APRIL 26, 2023

Resuscitation 2020. N Engl J Med 2019. Am Fam Physician 2019; 99:482. Classification of sepsis, severe sepsis and septic shock: the impact of minor variations in data capture and definition of SIRS criteria. Druyan A, Janovich R, Heled Y. Misdiagnosis of exertional heat stroke and improper medical treatment.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 52

PulmCCM

MARCH 1, 2022

General topics include: sepsis, resuscitation, COVID and ventilation, advanced hemodynamics, advanced POCUS, with spotlights on nephrology, general surgery, POCUS for hospitalists and lots else. For my previous H & R offerings, please see these old posts from 2018 , 2019 [ IVC , Doppler , ventilator waveforms ] and 2020.

Ultrasounds 40

Ultrasounds Resuscitation Sepsis 40