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FDA approves EMR-embedded sepsis prediction tool

PulmCCM

The FDA approved the first-ever AI-powered electronic medical record-based prediction model for sepsis: The Sepsis Immunoscore, by Prenosis. If you look under the hood, it suffers from the same fundamental limitation as all the rest: the lack of a reference standard (gold standard) for diagnosing sepsis.

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Cuffed Endotracheal Tubes for Children: ReBaked Morsel

Pediatric EM Morsels

2021 Jun;31(6):713-719. Epub 2021 Apr 11. 0.41), p < 0.001. References : To YH, Ong YG, Chong SL, Ang PH, Bte Zakaria ND, Lee KP, Pek JH. Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Paediatr Anaesth. doi: 10.1111/pan.14185. PMID: 33774880. Acad Emerg Med.

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Sepsis alerts work! Just not in the patients who fire the alerts

PulmCCM

In the past decade, so-called “sepsis alerts” came out of nowhere to become a ubiquitous and resource-intensive component of inpatient medical care. “Sepsis alerts” are automated notifications that flag patients who meet certain criteria compatible with severe infection discernible from the electronic medical record.

Sepsis 45
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Penetrating chest trauma

Don't Forget the Bubbles

In 2021, Evans and colleagues (1) compared adolescent mortality rates in adult, children’s and mixed major trauma centres across the UK. In 2021, Kulvatunyou, Bauman and colleagues compared the insertion of traditional 28-32Fr chest tubes with 14Fr pigtail catheters for drainage of traumatic haemothorax. Is he going to be OK?

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Dacryocystitis 

Don't Forget the Bubbles

Occasionally, lacrimal probing does not work, and an operation is needed. Sepsis: The spread of infection through the bloodstream, known as sepsis, is a critical condition that can lead to organ failure and death if not promptly treated. 2021 Jan 2;40(1):18-23. 2021 Dec;21(1):1-7. 2021 Feb 15;37(5):482-7.

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EM@3AM: Stercoral Colitis

EMDocs

Clinical exam: 2, 3, 9 Abdominal distension and tenderness Nausea and vomiting Stool present in the rectal vault Peritonitis may be accompanied by hemodynamic instability in the case of sepsis. 2-4, 6 If there is a concern for perforation or sepsis, surgical consultation, blood cultures, empiric antibiotics, and fluids are recommended.

EMS 72
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Bubble Wrap PLUS – January 2024

Don't Forget the Bubbles

However, children who had an operation experienced improvements in behaviour, symptoms, and quality of life and had lower blood pressure. Data collected from 2002 to 2021 revealed a 72% decline in IPD incidence among children (<18 years), with continued reductions after the transition from PCV7 to PCV13. Pawlowski TW, et al.