PulmCCM

JANUARY 6, 2025

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

Sepsis Documentation/Coding Hospitals Outcomes 45

EMDocs

JUNE 15, 2024

. #2: From the Doorway – How Accurate Is Physician Gestalt in Sepsis? Spoon Feed Physician gestalt significantly outperformed existing sepsis screening tools (SIRS, qSOFA, SOFA, and MEWS) in identifying sepsis early in critically ill, undifferentiated patients’ ED courses. JAMA Netw Open. 2024 Apr 1;7(4):e247373.

Sepsis 88

Sepsis Emergency Department 88

PulmCCM

JANUARY 23, 2025

Various new “sepsis tests” have come to market or will soon, claiming to solve the problem of diagnostic imprecision in the early management of suspected sepsis. The lack of a reliable diagnostic test or universally accepted criteria to diagnose sepsis leads to significant challenges in clinical practice and research.

Sepsis 45

Sepsis Wellness Emergency Department Research 45

JournalFeed

JUNE 12, 2021

It’s the JournalFeed Podcast for the week of Jun 7-11, 2021. We cover overuse of antibiotics for ED sepsis alerts, HEART or EDACS with hs-cTn 0-1 hour rule outs, ED-AWARENESS - paralysis awareness after RSI, thoracentesis or chest tubes in coagulopathic patients, and a review on managing the difficult airway.

Sepsis 52

Sepsis 52

JournalFeed

APRIL 24, 2021

It’s the JournalFeed Podcast for the week of Apr 19-23, 2021. We cover leadership through change, IN midazolam for pediatric seizure, hypothermia and young infant sepsis risk, VICTAS RCT, and clinically diagnosing GHB intoxication.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Seizures Sepsis Leadership 52

Emergency Medicine Cases

MARCH 1, 2022

The post EM Quick Hits 36 – Surviving Sepsis, Angle Closure Glaucoma, Bougies, Frostbite, Hot/Altered Patient, Central Cord Syndrome appeared first on Emergency Medicine Cases.

Sepsis 52

Sepsis EMS Fluid Resuscitation Hyperthermia / Hypothermia 52

Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. In middle-to-high-income countries, after 40-60ml/kg of fluid resuscitation, the Surviving Sepsis Campaign International Guidelines recommend using vasoactive drugs. After 40ml/kg of IV 0.9% The CRT is unchanged.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Date: September 20th, 2021 Reference: Litell et al. Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge. Date: September 20th, 2021 Reference: Litell et al. Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge.

Sepsis 40

Sepsis Emergency Department COPD Hospitals 40

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

EMDocs

NOVEMBER 7, 2023

Included patients had confirmed uncomplicated diverticulitis but no immunosuppression, peritonitis, sepsis. Patients with sepsis and immunocompromise were not included. 2021 Nov 1;274(5):e435-e442. No evidence of sepsis. Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. Br  Br J Surg.

Sepsis 100

Sepsis Best Practices Hospitals Outcomes 100

Taming the SRU

APRIL 17, 2024

The surviving sepsis guidelines weakly recommend invasive arterial blood pressure monitoring (IABP) over noninvasive blood pressure monitoring (NIBP) with a blood pressure cuff supported by low quality evidence.(1) Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.

Sepsis 93

Sepsis Research Stroke Academics 93

EMergucate

OCTOBER 19, 2021

The ECG below is from a 66 year old diabetic man who has presented with sepsis. Interpretation Rate: 72 Rhythm: … Continue reading →

EKG/ECG 52

EKG/ECG Sepsis 52

RebelEM

SEPTEMBER 21, 2023

Type 2 MI is common in the ED and can result from vigorous exercise (common in athletes after marathons), sepsis, trauma and tachydysrhythmias including SVT. Type 4: MI associated with percutaneous coronary intervention (Subtype 4a), or stent thrombosis (Subtype 4b). Type 5: MI associated with coronary bypass surgery.

EKG/ECG 143

EKG/ECG Sepsis EMS Outcomes 143

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives In 2021, the Surviving Sepsis Campaign International Guidelines advised clinicians to administer antimicrobials within 1h and 3h to sepsis patients with and without shock respectively. We aim to evaluate whether the timing of antibiotic administration in admitted sepsis patients affects mortality.

Sepsis 40

Sepsis Administration Shock 40

Don't Forget the Bubbles

APRIL 22, 2024

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. Isaza G, Arora S. Clinical and Investigative Medicine. 2013 Jun 1:E158-62.

Infectious Diseases 85

Infectious Diseases Sepsis Pediatrics Operations 85

Sensible Medicine

AUGUST 14, 2024

This sort of sepsis would produce many of the common autopsy findings. A 2021 AAP article by Parks and colleagues says, “Lack of uniformity in defining and classifying SUID is a long-standing limitation of surveillance. According to CDC data , 544 infants died per 100,000 live births in 2021.

CDC 95

CDC Sepsis Research Pediatrics 95

ALiEM

FEBRUARY 9, 2024

This is endorsed in the 2022 ACC pathway [1] and the 2021 AHA chest pain guidelines [7]. as seen in heart failure, arrhythmias, or sepsis). 2021 May 14;42(19):1908] [published correction appears in Eur Heart J. 2021 May 14;42(19):1925] [published correction appears in Eur Heart J. 2021 May 13;:]. J Am Coll Cardiol.

EKG/ECG 110

EKG/ECG Emergency Department Burns Wellness 110

Don't Forget the Bubbles

MAY 6, 2024

This multicentre retrospective cohort study looked at 202 children in California aged 1- 24 months who presented acutely between 2010 and 2021. Reviewed by: Tasnim Ransome and Spyridon Karageorgos Article 3: Which Sepsis Scoring Tools Perform Best? Each patient was scored using the four sepsis tools. Schlapbach, L.J.,

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

EMergucate

OCTOBER 19, 2021

The ECG below is from a 66 year old diabetic man who has presented with sepsis. Interpret the ECG How … Continue reading →

EKG/ECG 40

EKG/ECG Sepsis EMS 40

EMDocs

JANUARY 11, 2025

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 88

EMS Sepsis Shock Fluid Resuscitation 88

JournalFeed

JANUARY 30, 2021

It’s the JournalFeed Podcast for the week of Jan 25-29, 2021. We cover Project COVERED, interval likelihood ratios for pediatric UA, sepsis workup for infant otitis media, ARREST RCT - ECMO+CPR, and the best immobilization for dancer’s fractures.

Pediatrics 52

Pediatrics CPR Sepsis Fractures 52

EMDocs

JANUARY 9, 2024

McGraw Hill; 2021. Accessed August 28, 2022. link] Zafren K, Thurman R, Jones ID. Marine Dermatitis. In: Knoop KJ, Stack LB, Storrow AB, Thurman R. The Atlas of Emergency Medicine, 5e. Accessed August 25, 2022. link] Fil LJ, Tunik MG. Food Poisoning. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS.

Poisoning 95

Poisoning Burns Sepsis 95

Core Ultrasound

MARCH 25, 2024

Old IVC Vid (2021) TEE VTI Here are Dr. Spiegel’s Notes: 1. For example a pt in the ED with sepsis, and a collapsible IVC, dry lungs and no peripheral edema is more likely to benefit from fluid than be harmed Take that same pt, with the same US and physical exam findings and make it 72-hrs later in the ICU after 6-10 L.

Administration 75

Administration Sepsis Ultrasounds Outcomes 75

Don't Forget the Bubbles

JANUARY 1, 2024

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. During the COVID-19 pandemic (2020-2021), the incidence of IPD reached its lowest level in 20 years. Pawlowski TW, et al. Eur J Pediatr. Weiss SL, et al. Pediatrics.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

RebelEM

FEBRUARY 8, 2024

to 1.12; p = 0.03 for every change in 5ug/min Lower MAP Value: aOR 0.98; 95% CI 0.98 to 0.99; p <0.01 for every change in 1mmHg Higher BMI: aOR 1.04; 95% CI 1.01 to 1.09; p = 0.01 for an increase in 1 Increased Patient Age: aOR 1.31; 95% CI 1.30 to 1.37; p <0.01 for every 10 years Radial Arterial Line Location: aOR 1.74; 95% CI 1.16

Resuscitation 113

Resuscitation Outcomes EMS Sepsis 113

PulmCCM

AUGUST 21, 2023

The study was stopped in November 2021 due to the Covid-19 pandemic, at just over half of its intended enrollment, reducing its power. Performance was much higher for pneumococcal sepsis (which usually presents with more severe illness, rendering the biomarker less useful). There were no significant differences in adverse events.

Telemedicine 88

Telemedicine CDC Sepsis Outcomes 88

Taming the SRU

JULY 24, 2023

Complications of acute gallbladder perforation include localized peritonitis, hepatic, subhepatic, or pelvic abscess formation, pneumonia, pancreatitis, acute renal failure, and sepsis (7). In those with concern for sepsis, blood cultures, broad spectrum IV antibiotics and fluids should be given as needed. Int J Surg.

Ultrasounds 78

Ultrasounds Sepsis Radiology Radiology 78

The Skeptics' Guide to EM

OCTOBER 23, 2021

Date: October 20th, 2021 Reference: Talan et al. AEM October 2021 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. Date: October 20th, 2021 Reference: Talan et al. Excluded: Unstable comorbidity (e.g.

Emergency Department 52

Emergency Department Sepsis Hospitals Research 52

Broome Docs

AUGUST 2, 2022

Vitamin C in sepsis: STOP IT, we do not LOVE IT Lamontagne F, Masse MH, Menard J, et al; LOVIT Investigators and the Canadian Critical Care Trials Group. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. PMID: 35704292 Bottom line: Sepsis is not treated with vitamins. Epub 2021 Dec 7. N Engl J Med.

Sepsis 52

Sepsis Emergency Department Radiology Radiology 52

The Skeptics' Guide to EM

OCTOBER 3, 2021

Date: September 28th, 2021 Reference: Zampieri et al. JAMA 2021 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Consultant in […] The post SGEM#347: It Don’t Matter to Me – Balanced Solution or Saline first appeared on The Skeptics Guide to Emergency Medicine.

Outcomes 52

Outcomes Sepsis Administration Resuscitation 52

University of Maryland CC Project

MAY 19, 2021

About the AuthorJim Lantry Twitter Google+Just your average critical care doc: wandering the ED and ICUs of Maryland, dedicating time to the USAF to travel the globe to cannulate for ECLS wherever the need arises, and trying to keep up with great minds of today. E: JlantryMD@gmail.com Just your average.

Sepsis 40

Sepsis Shock 40

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

The Skeptics' Guide to EM

DECEMBER 11, 2021

Date: December 10th, 2021 Guest Skeptic: Dr. Carly Eastin is an Associate Professor, Division of Research and Evidence Based Medicine, Department of Emergency Medicine, University of Arkansas for Medical Sciences. Back in 2019 we were talking about Vitamin C for sepsis ( SGEM#268 ). Not much has changed over the last two years.

Sepsis 40

Sepsis Shock Outcomes Research 40

The Skeptics' Guide to EM

JANUARY 15, 2022

Intensive Care Med 2021 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a professor of Emergency Medical Services at Tacoma Community College’s paramedic program. Date: January 16th, 2022 Reference: Matchett, G. Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial.

Sepsis 42

Sepsis Shock Emergency Department Outcomes 42

EMDocs

JANUARY 25, 2025

PCP Pneumonia, Sepsis) can be discharged with initiation of Antiretroviral Therapy in consultation with Infectious Disease (ID) physician with full ID evaluation outpatient. Prevalence and risk factors of cytopenia in hiv-infected patients before and after the initiation of haart. BioMed Research International, 2020, 1-10. link] Lu, W.,

EMS 80

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 80

Taming the SRU

AUGUST 27, 2024

Mortality rates related to bullous skin lesions are typically related to disruption of the skin barrier and include subsequent dehydration, electrolyte imbalances, hypothermia, increased metabolic needs, and secondary infection leading to bacteremia and/or sepsis. J Am Acad Dermatol 2021; 84:1782. Nature 2004; 428:486. MRCP (n.d.).

Emergency Department 83

Emergency Department Dehydration Burns Sepsis 83

Broome Docs

APRIL 6, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. 2022 Dec 16:emermed-2021-211946. doi: 10.1136/emermed-2021-211946. Casey The CLOVERS trial: National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network; Shapiro NI, Douglas IS, Brower RG, et al.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52