RebelEM

FEBRUARY 8, 2024

were they in the resuscitative phase? were they in the resuscitative phase? This study does not address the utility of arterial lines vs NIBP in the acute resuscitative phase Author Conclusion: “There was broad agreement between IABP and NIBP in critically ill patients over a range of BPs and severity of illness. to 2.47; p – 0.04

Resuscitation 125

Resuscitation Outcomes EMS Sepsis 125

Don't Forget the Bubbles

AUGUST 7, 2023

Heart rate (HR) and respiratory rate (RR) are THE major vital signs used in Advanced Paediatric Life Support ( APLS) guidance , sepsis guidelines , and Paediatric Early Warning Scores (e.g., Identify the percentage of children whose heart or respiratory rate would exceed the “severe” cut-off from the UK Sepsis Trust and NICE guidelines.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

The Skeptics' Guide to EM

JUNE 6, 2020

Date: June 2nd, 2020 Reference: Permpikul et al. Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Date: June 2nd, 2020 Reference: Permpikul et al. Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Respir Crit Care Med 2019.

Sepsis 52

Sepsis Shock Resuscitation Administration 52

EMDocs

NOVEMBER 1, 2023

1 , 4 If presenting later in course or with an intra-abdominal perforation, patients are more likely to show signs of sepsis and hemodynamic instability. VBG with lactate 4 – may show low pH with elevated lactate Cardiac biomarkers – to evaluate for cardiac etiology in those presenting with chest pain or type II NSTEMI in those with sepsis.

Operations 93

Operations Radiology Radiology Fluid Resuscitation 93

EMDocs

OCTOBER 19, 2024

Blood cultures: Blood cultures are rarely positive; however, should be obtained if suspicion for sepsis is present or if the patient is immunocompromised. [2][3] 2][3] Management/Disposition ABCs and resuscitation if indicated Assessment for need of definitive airway is imperative as rate of intubation is high (38-100%) in various studies. [2][3][9]

EMS 110

EMS Pediatrics Sepsis Airway Management 110

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. N Engl J Med. 2023;388(6):499-510. 2019, Bauer, Gerlach et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

PulmCCM

FEBRUARY 28, 2022

What they did Adult patients admitted to one of 53 intensive care units in New Zealand or Australia between September 2017 and December 2020 were eligible. Patients were thus excluded if they had indications for a specific type of IV fluid resuscitation or if they had received more than 500 mL of IV fluid in the ICU.

Fluid Resuscitation 40

Fluid Resuscitation Resuscitation Outcomes Sepsis 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? 2020 Nov 21;41(44):4258]. Ann Emerg Med.

Shock 105

Shock Emergency Department Pediatrics EKG/ECG 105

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

The Skeptics' Guide to EM

JANUARY 25, 2020

Date: January 9th, 2020 Reference: Casey et al. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Date: January 9th, 2020 Reference: Casey et al. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound.

EMS 40

EMS Airway Management Administration Resuscitation 40

Northwestern EM Blog

FEBRUARY 14, 2022

Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation. Published online October 21, 2020. Two classes of vasopressors have been used in the past for hypotension. 2021;159(2):596-605. doi:10.1016/j.chest.2020.08.2074

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

EM Updates

JUNE 15, 2021

In the last week of March and first week of April 2020, hospitals across New York City were overwhelmed with critically ill COVID-19 patients, many of whom had unprecedented oxygen requirements. From April 6 to May 3, 2020, 90 patients were admitted to the EDAT. 2020;e203391. and Emergency Medicine residents, in 12 hour shifts.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

Mind The Bleep

SEPTEMBER 12, 2023

Were there any risk factors for sepsis? Did the baby need resuscitating? Increased work of breathing with grunting and tachypnoea could be due to sepsis, hypoglycaemia or acidosis due to an inborn error of metabolism. Birth History How long was the labour? What were the APGAR signs? Were they cooled? Were the cord gases poor?

Sepsis 52

Sepsis Seizures Poisoning Wellness 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. 2020 Mar;5(3):245-66. doi: 10.1136/gutjnl-2020-321790. Epub 2020 Oct 16.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

Thinking Critical Care

MAY 18, 2023

To everybody outside Glasgow glucocorticoids seemed to be the answer and Chicago surgeon William Schumer was their chief flag waver, claiming in 1976 that steroid therapy reduced the mortality of saline-treated sepsis in his service from 33% to around 10%. [5] I do not recall one experiment getting as far as the resuscitation stage.

Shock 40

Shock Research Sepsis Resuscitation 40

Dr. Smith's ECG Blog

MAY 19, 2020

pulmonary embolism, sepsis, etc.), Shark Fin morphology has been discussed a number of times on Dr. Shark Fin morphology has been discussed a number of times on Dr. Smith’s ECG Blog ( For review — See the June 11, 2018 post and the January 24, 2020 post , to name just 2 instances ). 24, 2020 post ( link to that post given above ).

CPR 52

CPR EKG/ECG Shock Ultrasounds 52

Mind The Bleep

FEBRUARY 9, 2024

48 hours) to help her through the initial period of sepsis while her antibiotics take time to work. Because she would not be for intubation, they discuss resuscitation status because, naturally, care during- and post-arrest would involve airway support. The patient and team agree to instate a u-DNACPR. ABC of intensive care.

Hospitals 52

Hospitals Resuscitation Fluid Resuscitation Shock 52

Don't Forget the Bubbles

JUNE 10, 2024

Systemic Infections : Sepsis and other systemic infections can predispose infants to NEC by compromising the gut barrier and promoting inflammation. Differential diagnoses include septic ileus, and infection causes such as sepsis, meningitis and pneumonia. How do we diagnose necrotising enterocolitis? ANZNN Annual Report.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Taming the SRU

APRIL 26, 2023

Resuscitation 2020. Classification of sepsis, severe sepsis and septic shock: the impact of minor variations in data capture and definition of SIRS criteria. J Intensive Care Med 2015. Douma MJ, Aves T, Allan KS, et al. 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

EMDocs

JUNE 27, 2024

2020 Feb 12;10(1):2470. -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 97

Pediatrics Dehydration EMS Hospitals 97

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 mg/kg (of 0.1 mg/kg (of 0.1 2x maintenance rate

Psychiatric 89

Psychiatric Seizures Emergency Department Pediatrics 89

Thinking Critical Care

NOVEMBER 28, 2021

Essentially the F2F conference will be 100% interactive, as the long conversations are meant to address the topics that don’t lend themselves well to, or require hands-on workshops (eg sepsis and complex hemodynamics). Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Sepsis 52

Sepsis Airway Management Wellness Resuscitation 52

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. In lower-resource settings, the evidence is stronger against a liberal approach to volume resuscitation.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

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. He has had some additional episodes of hypotension post-intubation, which is treated with further volume resuscitation. Indian J Crit Care Med, 2020. Ultrasound J, 2020.

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78

Taming the SRU

FEBRUARY 3, 2025

Additional Treatments for Severe Electrolyte Derangements Severe Hyperuricemia If uric acid 8 mg/dL or 25% increase from baseline develops, then rasburicase should be administered in addition to IV fluid resuscitation. McGraw-Hill Education; 2020:962-963. original document created by author of post. Accessed January 21, 2025.

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56