EM Literature of Note

SEPTEMBER 13, 2024

Most regions used a strategy in which nirsevimab was provided to new births during RSV season, as well as other young infants born prior to the onset of the season. The two “COVID seasons” of 2020-21 and 2021-22 were excluded from their comparisons.

Emergency Department 87

Emergency Department Pediatrics Administration Wellness 87

EMDocs

JULY 1, 2023

Kawasaki disease: a comprehensive review. link] Clinical Practice Guidelines: Kawasaki Disease. Updated January 2021. Kawasaki disease: clinical features and diagnosis. Incomplete (atypical) Kawasaki disease. He has had a high fever of > 103°F (39.4°C) C) for the past week. Arch Med Sci Atheroscler Dis.

EMS 76

EMS Infectious Diseases Pediatrics Research 76

Pediatric Education

NOVEMBER 19, 2023

They felt he was breastfeeding well and had only mild jaundice. His examination was normal and the diagnosis of a well newborn infant was made. mg/dL which was well below treatment threshold. Some infants may need car seat tolerance screening as well. 2021-055554 Shaw MA, Liu A. BMC Pediatr. 2021;21(Suppl 1):350.

Infectious Diseases 40

Infectious Diseases Administration Pediatrics Wellness 40

ALiEM

AUGUST 21, 2023

History of trauma or penetrating injury and immunocompromised status should raise suspicion for infectious flexor tenosynovitis; common pathogens include Staphylococcus and Streptococcus species. Treatment includes emergent consultation with orthopedics or hand surgery as well as early initiation of IV antibiotics. McGraw Hill; 2021.

Academics 52

Academics Outcomes Hospitals Wellness 52

ALiEM

AUGUST 14, 2023

Treatment is appropriate antibiotics and improved foley hygiene, foley exchange as well as improved bowel regimen to increase stool transit time. It is predominantly found in women, chronically catheterized, institutionalized, and constipated patients. References Meekins Pauline, Ramsay Amy, Ramsay Michael. Purple Urine Bag Syndrome.

Academics 52

Academics Wellness Infectious Diseases 52

Pediatric EM Morsels

JANUARY 19, 2024

Unfortunately, the possibility of congenital infections always looms large as well, including congenital syphilis. In 2021 there were almost 177,000 cases of syphilis. CDC 2023] In 2021, there were over 2800 cases of congenital syphilis, tripled from 2017. THEN- 50,000 units/kg per dose IV every 8 hours for 10 to 14 days.

Infectious Diseases 269

Infectious Diseases CDC Pediatrics Fractures 269

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 Infectious Diseases 52

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. Groups were well matched at baseline. Were the study groups similar at the start of the trial?

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

Pediatric EM Morsels

OCTOBER 6, 2023

The most common countries of acquisition were Bangladesh, India, Nepal, and Pakistan (Forster 2021) For travelers, the peak incidence occurs at age 10 and those who are visiting to their country of birth. Rauniyar 2021) Up to 10% of patients may present with constipation as opposed to diarrhea. Shah 2021).

Pediatrics 161

Pediatrics CDC Seizures Documentation/Coding 161

Pediatric EM Morsels

AUGUST 18, 2023

(Jackson 2016) It can also be used in UTIs , but is typically reserved for special cases where the infectious bacteria is found to be multidrug resistant or in complicated UTIs. Ross 2021) Predisposing risk factors including older age , trauma to tendons or joints , and a family history of MAEs. BMC Infectious Disease.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

PEMBlog

OCTOBER 18, 2023

The night prior to presentation, mom noticed he was not feeding as well and seemed fussy. Initially in the emergency department he was generally well-appearing with normal vital signs. Infants with NTED generally remain well-appearing and do not meet toxic shock syndrome (TSS) criteria. Overnight, she had to wake him to feed.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

Pediatric EM Morsels

SEPTEMBER 20, 2024

Though most children recover well after STEC is cultured from their stool, some will go on to display the findings that make up HUS. 2021 May;232:200-206.e4. Epub 2021 Jan 5. The most notable varietal of the STEC is E.coli 0157:H7 (do you remember that from medical school?). doi: 10.1016/j.jpeds.2020.12.077. 2020.12.077.

Pediatrics 161

Pediatrics Ultrasounds Dehydration Emergency Department 161

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. A 2015 meta-analysis of 9 studies consisting of 725 patients published in the International Journal of Infectious Diseases found PCT far superior to CRP, with PCT having a sensitivity of 90 and specificity of 98% [36]. J Med Virol.

Infectious Diseases 88

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

EMDocs

DECEMBER 18, 2023

The most recent surviving sepsis campaign (SSC) guidelines were released in 2021, which provided 93 recommendations for evidence-based sepsis management. 1 Since 2021, attempts to identify a single screening tool with optimal sensitivity and specificity to predict which patients will develop sepsis or septic shock have been ongoing.

Sepsis 75

Sepsis Fluid Resuscitation Resuscitation Shock 75

EMDocs

JULY 15, 2023

The patient reported feeling better, pain and other symptoms were well controlled 24 hours after starting antibiotics and pain medication. The border may be raised, but erysipelas does not cause overt superficial skin lesions that other infectious rashes might cause (e.g., 2021, May 18). Infectious Diseases Society of America.

EMS 76

EMS Infectious Diseases Shock Ultrasounds 76

EMDocs

APRIL 27, 2024

Infectious diseases , 4 (1), 34–39. Infectious diseases, 4(1), 34–39. and Staphylococcus spp. 2 F ungal involvement (usually Aspergillus fumigatus ), especially in immunocompromised patients. The changing face of malignant (necrotising) external otitis: clinical, radiological, and anatomic correlations. The Lancet.

EMS 96

EMS Infectious Diseases Radiology Radiology 96

Mind The Bleep

SEPTEMBER 17, 2024

Management The management is guided by the examination findings which are covered in the respective chapter, this section will delve into the importance of a number of those steps, as well as further long-term care. Sci Rep 11, 1767 (2021). Always consider management as per ATLS protocol and SEPSIS 6 if relevant. Tulloch, J.S.P.,

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

PEMBlog

JULY 10, 2024

[link] Centers for Disease Control and Prevention. “Sexually Transmitted Disease Surveillance 2021.” ” Centers for Disease Control and Prevention, 2021. Centers for Disease Control and Prevention. “Sexually Transmitted Infections Treatment Guidelines 2021.”

Pediatrics 52

Pediatrics CDC Seizures Emergency Department 52

RebelEM

AUGUST 3, 2023

What They Did: Parallel, 2-arm, noninferiority, open-label, multicenter, international randomized clinical trial Occurred in 6 specialized centers (3 in North America – US & Canada and 3 Outside of North America – Australia) Trial took place from June 2021 to December 2022 Used PEN-FAST to risk stratify patients.

Anaphylaxis 52

Anaphylaxis Allergic Reactions Outcomes Infectious Diseases 52

Don't Forget the Bubbles

SEPTEMBER 23, 2024

This is particularly crucial in younger children who have received a large adult kidney and typically have relatively low creatinine levels when stable and well. Additionally, any child with a kidney transplant might have some degree of chronic kidney disease (CKD). When in doubt, call the team. and Hirsch, H.H., Chandran, M.M.

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Mind The Bleep

NOVEMBER 20, 2024

Infectious disease (ID) is much more than simply collecting blood cultures; it’s a dynamic and exciting specialty that offers the opportunity to work with patients of all ages, varying acuities, and diverse clinical presentations. Contents What makes ID a great career choice? What makes ID a great career choice?

Infectious Diseases 52

Infectious Diseases Research Patient Safety Outcomes 52

Dr. No

JANUARY 27, 2022

The effect of this rule, as noted, is that the infectious diseases listed, including covid–19, almost always trump other potentially valid underlying causes of death. With the caveats established, Table 1 shows the average annual numbers of deaths for common causes for 2015-2019, and the numbers in 2020 and 2021.

Documentation/Coding 52

Documentation/Coding Infectious Diseases Wellness 52

EMDocs

JANUARY 6, 2025

She receives IV calcium gluconate and bicarbonate as well as oral potassium binders for hyperkalemia. Case Resolution The patient and family remain in isolation and receive risk stratification assessment for a notifiable disease of public health concern. Hypoglycemia is managed with IV dextrose. 12 Table 1.

Infectious Diseases 67

Infectious Diseases CDC PPE Rapid Diagnostic Testing 67

EMDocs

NOVEMBER 2, 2024

A broad workup is initiated for altered mental status, including an STD panel, which shows a reactive Venereal Disease Research Laboratory (VDRL) and a negative CT head. Consultation with an infectious disease and neurology specialist can be considered to guide treatment and proper disposition. 27,4 (2021): 1018-1039.

EMS 104

EMS Infectious Diseases CDC Research 104