EMDocs

SEPTEMBER 7, 2024

Clinical features include abdominal or flank pain; ecchymosis to the flank, periumbilical region, proximal thighs, or scrotum; and hemorrhagic shock early in the disease course. 2020 May;13(5):545-555. Epub 2020 Mar 3. 2020 Jun;13(6):i. angioembolization). Expert Rev Hematol. doi: 10.1080/17474086.2020.1733963.

EMS 58

EMS Fluid Resuscitation Resuscitation Radiology 58

Dr. Smith's ECG Blog

FEBRUARY 16, 2020

A previously healthy 53 yo woman was transferred to a receiving hospital in cardiogenic shock. Referring to Figure-1 — this 53-year old woman who presented in extremis with cardiogenic shock and an initial pH = 6.9, This was sent by a reader. and K was normal. Here was the ECG: There is sinus tachycardia.

Shock 52

Shock Hyperthermia / Hypothermia EKG/ECG Hospitals 52

Pediatric EM Morsels

APRIL 5, 2024

This is true of hard ticks , which carry the majority of bacteria and viruses which can infect humans (Rochlin 2020) This is not true when the infectious agent is carried by a soft tick. Rochlin 2020) Shares many of the same symptoms as African tick-bite fever. In the US, outbreaks have been linked to rental cabins near national parks.

CDC 161

CDC Infectious Diseases Pediatrics Wellness 161

EMDocs

JANUARY 23, 2024

Episode 93: BRASH syndrome Background: Brash syndrome has 5 components: bradycardia, renal failure, AV nodal blocker, shock, hyperkalemia. BRASH Syndrome: Bradycardia, Renal Failure, AV Blockade, Shock, and Hyperkalemia. 2020 Aug;59(2):216-223. BRASH syndrome: Bradycardia, Renal failure, Av blocker, Shock, and Hyperkalemia.

Shock 87

Shock Dehydration Sepsis EKG/ECG 87

Thinking Critical Care

JUNE 5, 2024

while the R side will deep-dive bedside hemodynamics and our 4-interface model of shock management. Day 2 – The R “Fluids and Shock Hemodynamics” 0800-0830 – Intro to the circuit & interfaces – CRAGER 0830-0900 – What is Coupling?

Shock 72

Shock Hospitals Wellness Resuscitation 72

EB Medicine

NOVEMBER 17, 2020

Write us at emplify@ebmedicine.net.

Emergency Department 40

Emergency Department Shock Resuscitation CPR 40

The Skeptics' Guide to EM

AUGUST 14, 2021

Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Circulation 2020 Guest Skeptic: Missy Carter is a PA practicing in emergency medicine in the Seattle area and an adjunct faculty member with the Tacoma Community College paramedic program.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

ALiEM

MAY 29, 2023

If left untreated, it can lead to significant blood loss, shock, airway obstruction, and even death. Symptoms of massive epistaxis include sudden and heavy bleeding from the nose, difficulty breathing, dizziness, and a rapid heartbeat. For our case, this dual catheter compression technique succeeded in halting the bleed.

Blood Transfusions 98

Blood Transfusions Emergency Department Shock Hospitals 98

JournalFeed

DECEMBER 26, 2020

It’s the JournalFeed Podcast for the week of Dec 21-25, 2020. We cover the pros and cons of NSAIDs for adult fractures, the accuracy of COVID-19 antibody testing, angiotensin II for refractory shock, and a Merry Christmas song!

Fractures 52

Fractures Shock 52

JournalFeed

OCTOBER 3, 2020

28- Oct 2, 2020. We cover the new ACEP opioid policy statement, PE response teams during COVID-19, a SMART balanced fluid trial spin-off in septic shock, an AHA statement on drug-induced arrhythmia, and use of POCUS for shoulder dislocation. It’s the JournalFeed Podcast for the week of Sept.

Dislocations 52

Dislocations Sepsis Shock 52

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 Outcomes 52

JournalFeed

SEPTEMBER 5, 2020

We cover a review of acute ischemic stroke, ACP/AAFP musculoskeletal pain guidelines, antibiotics for cirrhosis with upper GI bleed, early norepinephrine for septic shock, and the best way to tape an ETT so it won’t come out. It’s the JournalFeed Podcast for the week of Aug. 31 - Sept.

Stroke 52

Stroke Shock 52

Dr. Smith's ECG Blog

MAY 3, 2024

She was found by medics agitated, hypotensive, diaphoretic, and in shock. But this time the Queen gets it wrong (thinks it is not OMI): There were runs of VT: Tha patient arrived in profound shock and had an ED ECG: Now there is some evolution to include the ST elevation (rather than ST depression) in V4-V6.

Shock 113

Shock EKG/ECG Hospitals EMS 113

EB Medicine

JUNE 18, 2020

EMplify June 2020 Multi-system Inflammatory Syndrome in Children (MIS-C) with COVID-19: An Interview with Dr. Ilene Claudius and Dr. Mohsen Saidinejad. Shock: cardiogenic and distributive shock presentations. Shock: cardiogenic and distributive shock presentations. Is clinical shock a requirement?

Shock 40

Shock Pediatrics Hospitals 40

Taming the SRU

MAY 5, 2023

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. Each subsequent one-hour delay in antimicrobial administration increases mortality by 35% in patients with septic shock (Im, Kang et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

RebelEM

JANUARY 18, 2024

septic shock) earlier antibiotics most likely makes a difference in morbidity and mortality, however earlier antibiotics in all patients who meet SIRS criteria may not be a good thing and potentially cause more harms than good. to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

Sepsis 121

Sepsis Hospitals Administration Outcomes 121

PulmCCM

NOVEMBER 27, 2023

Beta-blockers for septic shock (STRESS-L trial) Septic shock deranges multiple complex signaling systems in the body. A meta-analysis of 7 randomized trials (n=503) previously suggested that co-administration of esmolol to blunt vasopressor-induced tachycardia and arrhythmias could reduce mortality in septic shock by one-third.

Sepsis 52

Sepsis Shock Administration Outcomes 52

Thinking Critical Care

MAY 18, 2023

In 1983 I was an Englishman abroad, the London anaesthetist who was appointed to be the English anaesthetist on the Shock Team only because the outstanding candidate from Oxford had preferred to take up a job doing muscle relaxant research with Kitz and Katz in the USA. 4] The research agenda at the time was broad.

Shock 40

Shock Research Sepsis Resuscitation 40

Taming the SRU

JUNE 24, 2024

Follow this algorithm in patients with unstable bradycardia with acute heart failure, change in mental status, or concern for shock, physicians should start with atropine, 1 mg and may be continued every 3 to 5 minutes if effective. Bektas, Firat, and Secgin Soyuncu. The efficacy of transcutaneous cardiac pacing in ED.”

Advances Cardiac Life Support (ACLS) 83

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 83

Northwestern EM Blog

FEBRUARY 14, 2022

The ATHOS-3 trial in 2017 explored the efficacy of angiotensin II as a vasopressor for severe vasodilatory shock. 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. were more likely to respond.

Shock 52

Shock Resuscitation Outcomes Fluid Resuscitation 52

Pediatric EM Morsels

FEBRUARY 2, 2024

Hospitalization for travel-related illness are around 10% for both VFR and tourists (Leuthard 2015) Multiple studies have reported the most common travel infections in various countries.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

Dr. Smith's ECG Blog

JANUARY 1, 2024

AslangerE A 65-year-old gentleman presented to the emergency department after experiencing two recent ICD shocks in the preceding hours. The subsequent ECG, taken 5-10 minutes post-shock, depicted a soothing of ST deviation. See My Comment at the bottom of the page in the May 19, 2020 post in Dr. Smith's Blog ).

EKG/ECG 96

EKG/ECG Shock Administration Emergency Department 96

Ken Grauer, MD

OCTOBER 21, 2023

Subendocardial Ischemia from another Cause ( ie, sustained tachyarrhythmia; cardiac arrest; shock or profound hypotension; GI bleeding; anemia; "sick patient" , etc. ). The August 22, 2020 post in Dr. Smith's ECG Blog — which illustrates another case of dynamic ST-T wave changes that resulted from a repolarization variant.

EKG/ECG 256

EKG/ECG Shock Wellness 256

ACEP Now

MAY 9, 2024

JHS’ chart review project, which identified 163 patients presenting to the ED with gluteal AFT complications in a 30-month period between 2020 and 2023, provides one of the most comprehensive and informative datasets on the breadth of AFT complications as they are currently being performed. Accessed March 6, 2024. Aesthet Surg J.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

The Skeptics' Guide to EM

DECEMBER 11, 2021

. * Fujii et al ( VITAMINS RCT) JAMA 2020: n=216 patients with septic shock. Moskowits et al ( ACTS RCT) JAMA 2020: n=205 patients with septic shock. no statistical difference in primary outcome of SOFA scores at 72 hours or the secondary outcome of 30-day mortality.

Sepsis 40

Sepsis Shock Outcomes Research 40

EMDocs

FEBRUARY 12, 2024

First, there can be a poor correlation between venous and arterial gases in states of shock, hemodynamic instability, or extremes of acid-base disturbances, due to poor cardiac output/circulatory failure impairing venous and arterial flow, with associated poor gas exchange as well as hypercapnia and acidemia at the tissue level (8).

Emergency Department 94

Emergency Department Resuscitation COPD Shock 94

Greater Sydney Area HEMS

APRIL 26, 2023

In contrast, shock (leading to syncope and rarely cardiac arrest) from ST can occur well before mechanisms of crush injury come into play, with low-flow states described as early as within 6 minutes (2). . 2020 Jun 8;12(6):e8514. 2020 Jun 8;12(6):e8514. Nope they’re different. Organ failure from rhabdo? doi: 10.7759/cureus.8514.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Shock Research Operations 52

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case presented in cardiogenic shock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. As I review in My Comment in the January 16, 2020 post of Dr. Smith's ECG Blog ( and have reproduced in Figure-2 below ) — the ECG of patients with acute LMCA occlusion may be varied.

EKG/ECG 112

EKG/ECG Shock Hospitals Sepsis 112

Mind The Bleep

JULY 15, 2023

Moroni G, 2020) Congenital nephrotic syndrome is extremely rare and presents within 3 months of birth. If a child presents acutely unwell with nephrotic syndrome they are likely to be in hypovalaemic shock, have an infection, or both. In secondary MN there may be subepithelial deposits of IgG1, IgG2, IgG3, C1q, IgA, IgM. Daehn IS, D.

Allergic Reactions 52

Allergic Reactions Shock Hospitals Wellness 52

ALiEM

JUNE 5, 2023

Glucocorticoid therapy should be considered in anthrax meningitis, cutaneous anthrax with extensive tissue edema involving the head and neck, or anthrax with vasopressor-resistant shock [9]. Published 2020 May 12. When should you administer post-exposure prophylaxis (PEP)? Accessed on April 16, 2023. Savransky V, Ionin B, Reece J.

Infectious Diseases 102

Infectious Diseases CDC PPE Military 102

Ken Grauer, MD

FEBRUARY 28, 2023

These 2 settings are: i ) In patients with severe , often longstanding pulmonary disease ; and / or , ii ) In acutely ill patients with multi-system disease ( ie, sepsis, shock, electrolyte and/or acid-base disorders ). These cases provide insight to assessment for MAT: The January 5, 2020 post in Dr. Smith’s ECG Blog — for an example of MAT.

EKG/ECG 195

EKG/ECG Documentation/Coding Sepsis COPD 195

Emergency Medicine Ireland

OCTOBER 16, 2023

The incidence of dynamic LVOTO in those with septic shock is remarkably high and is reported to be 20% in one study from ICU echo guru Michel Slama. Even if it’s not that common it’s yet another reason why the super shocked patient should get a timely echo. Echocardiogr Mt Kisco N Y 37 , 822–831 (2020).

Sepsis 52

Sepsis Shock Wellness 52

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Outcomes 52

The Skeptics' Guide to EM

SEPTEMBER 6, 2020

Date: August 27th, 2020 Guest Skeptic: Dr. Malthaner is the Chair/Chief of the Division of Thoracic Surgery, Director of Thoracic Surgery Research and Simulation, and Professor in the Departments of Surgery, Oncology, and Epidemiology and Biostatistics at the Schulich School of Medicine and Dentistry and Western University.

Research 40

Research Emergency Department Shock Hospitals 40

The Skeptics' Guide to EM

FEBRUARY 25, 2023

He is found to be in hypoxic respiratory failure and septic shock. Case: A 6-month-old boy presents to the emergency department (ED) with three days of worsening cough, cold symptoms, and fever. Parents note that he has been progressively more tired and difficult to arouse. Intravenous (IV) access is obtained. He is quickly intubated.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

Sensible Medicine

AUGUST 14, 2024

In his work, Dr. Goldwater describes a kind of toxic-shock (cytokine) reaction in the body that results from the combination of a cold virus plus being infected with a common bacterium—each pathogen relatively harmless on its own but deadly together. million babies born in 2020, and the CDC reports there were about 1,389 SIDS deaths.

CDC 77

CDC Sepsis Research Pediatrics 77

RebelEM

APRIL 29, 2024

Studies have compared IO to peripheral intravenous (PIV) and central venous (CVC) access for resuscitation. Resuscitation. 2012 PMID: 21893125. 9 Zhang W et al. Intravenous vs intraosseous adrenaline administration in cardiac arrest: A protocol for systematic review and meta-analysis. Medicine (Baltimore). PMID: 33350794 10 Meilandt C. Resusc Plus.

Resuscitation 102

Resuscitation Administration Emergency Department Hospitals 102