Remove 2021 Remove Sepsis Remove Stroke
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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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EM@3AM: Brainstem Strokes

EMDocs

Answer : Brainstem stroke specifically in the pons resulting in locked in syndrome. CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis?

Stroke 111
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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 98
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A Beginner’s Guide to Vasoactive Drug use in Children with Septic Shock

Don't Forget the Bubbles

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. The amount of blood that comes from the heart with each contraction is the stroke volume (SV). The stroke volume is the difference between how full it is at the start and how full it is after a contraction.

Shock 143
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Is a Cuff Enough?

Taming the SRU

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 94
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Non-Invasive Blood Pressure Monitoring in Critically Ill Adults?

RebelEM

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

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Diagnostics: Inflammatory Markers

Taming the SRU

Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear. A 2013 meta-analysis of 30 studies including 3,244 patients published in The Lancet found PCT to have a pooled sensitivity of 77% and specificity of 79% for sepsis in critically ill patients [52]. 2021; 93: 4358–4369.