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. A 45-year-old outdoor enthusiast presents to the emergency department with fever, headache, myalgias, and malaise. Philadelphia, PA: Elsevier; 2022:1-11.

EMS 95

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 95

Don't Forget the Bubbles

MARCH 31, 2025

The value of white blood cell count in predicting serious bacterial infections in children presenting to the emergency department: a multicentre observational study Archives of Disease in Childhood 2025;110:191196. Reviewed by Dr Faye Leggott Article 2: Does fluid overload increase mortality in children with sepsis?

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. 2023 May 17:archdischild-2022-325280. doi: 10.1136/archdischild-2022-325280. Arch Dis Child. Why was the DIMPLES study needed?

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

Northwestern EM Blog

MARCH 1, 2025

There are several etiologies including viral pneumonia, bacterial pneumonia, sepsis, trauma, and pancreatitis. This maneuver improves oxygenation and gas exchange via three main mechanisms (Malhotra, 2022): 1. What are the physiologic effects of proning?

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

ACEP Now

MAY 9, 2024

Unfortunately, at least 13 deaths were subsequently reported in Miami-Dade County from 2019–2022, the three years immediately following the implementation of the subcutaneous injection regulation. 6 Theoretically, ultrasound guidance should decrease this risk, which formed the basis for the 2022 Florida Medical Board regulation.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 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. 2022 Jun 23;386(25):2387-2398. PMID: 35704292 Bottom line: Sepsis is not treated with vitamins.

Sepsis 52

Sepsis Emergency Department Radiology Radiology 52

RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. 2022 Feb 8; PMID: 35156050 Higgins TL et al. 2022 Feb 24;7(1):29603. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Reviewed by: John Coveney Article 2: How do we define sepsis in children?

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

RebelEM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.

Emergency Department 52

Emergency Department Administration Dehydration EMS 52

EB Medicine

JANUARY 3, 2023

In this episode, Sam Ashoo, MD, interviews Ara Festekjian, MD, one of the authors of the November 2022 Pediatric Emergency Medicine Practice article on Pediatric Septic Shock in the Emergency Department Introduction: How common is sepsis in kids and what is the mortality rate in the US?

Shock 52

Shock Pediatrics Airway Management Sepsis 52

Don't Forget the Bubbles

JUNE 30, 2023

Importantly, there were no differences between the groups regarding complications, including acute respiratory distress syndrome, multiple organ failure, venous thromboembolism, sepsis, and transfusion-related complications. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this. c) Or, do both?

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

EMDocs

OCTOBER 8, 2024

The full differential diagnosis of sinus tachycardia in isolation is extensive ranging from benign etiologies such as anxiety to severely life threatening etiologies such as sepsis. Treasure Island (FL): StatPearls Publishing; April 30, 2022. Unanticipated death after discharge home from the emergency department.

Shock 105

Shock Emergency Department Pediatrics EKG/ECG 105

Taming the SRU

AUGUST 30, 2023

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

Taming the SRU

MAY 5, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. 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. N Engl J Med. 2023;388(6):499-510.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Don't Forget the Bubbles

MAY 17, 2023

This month’s list features answers to intriguing questions such as: ‘ Is the neonatal sepsis calculator useful if women were not screened for GBS? ’, ‘ Who can best score postoperative pain: parents or the children? ’, ‘ Is functional constipation associated with hypohydration? 2023 Apr 20:fetalneonatal-2022-324835. Tritos NA, et al.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

EMDocs

JULY 29, 2023

A 75-year-old male with past history of HTN, CVA, DM II presents to the emergency department with right facial swelling since last night. WikEM, The Global Emergency Medicine Wiki. Emergency Medicine Residents’ Association; 2022. We’ll keep it short, while you keep that EM brain sharp. RR 18, SpO2 97% on RA.

EMS 96

EMS Dehydration Ultrasounds Emergency Department 96

The Skeptics' Guide to EM

JANUARY 15, 2022

Date: January 16th, 2022 Reference: Matchett, G. Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Date: January 16th, 2022 Reference: Matchett, G. Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial.

Sepsis 43

Sepsis Shock Emergency Department Outcomes 43

The Skeptics' Guide to EM

JULY 16, 2022

Date: July 16th, 2022 Reference: Lamontagne F et al. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University.

Sepsis 40

Sepsis Shock Outcomes EMS 40

Taming the SRU

JUNE 11, 2023

End-tidal carbon dioxide measured at emergency department triage outperforms standard triage vital signs in predicting in-hospital mortality and intensive care unit admission. Acad Emerg Med 2023; 10.1111/acem.14703 West J Emerg Med. Am J Emerg Med. Acad Emerg Med. 2023;(December 2022):1-10.

Hospitals 88

Hospitals Emergency Department EMS Outcomes 88

Broome Docs

APRIL 6, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. Emerg Med J. 2022 Dec 16:emermed-2021-211946. Am J Emerg Med. Epub 2022 Nov 21. 2022 Jul 2;400(10345):39-47. A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

EMDocs

MAY 11, 2024

Cavernous sinus syndrome (B) usually presents with cranial nerve deficits, diplopia, periorbital cellulitis, and facial swelling that may progress to meningitis or sepsis. Clinical Policy: Use of Intravenous Tissue Plasminogen Activator for the Management of Acute Ischemic Stroke in the Emergency Department. Ann Emerg Med.

Stroke 110

Stroke EMS EKG/ECG Radiology 110

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Pain / Additional Complaints : Alcohol can weaken the immune system with only moderate use, predisposing individuals to pneumonia, soft tissue infections, and sepsis. Annals of Emergency Medicine.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

Northwestern EM Blog

JANUARY 24, 2022

Acidosis Acidosis in shock states can present from multiple different sources, including sepsis, hypoxemia, ingestions, hyperlactatemia from hypoperfusion, amongst others. Hypothyroidism and Adrenal Insufficiency in Sepsis and Hemorrhagic Shock. Emergency Medicine Clinics of North America. 2022, Jan 24). 2008;14:379-83.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

ACEP Now

OCTOBER 10, 2023

A 76-year-old female presents to the emergency department obtunded with left hemiplegia. 1,2 The 2022 AHA/ASA Guidelines give several recommendations on this topic. External Validity: It is unclear if this data applies to patient you see in your emergency department. Symptoms began just prior to presentation.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

RebelEM

NOVEMBER 3, 2022

Matchett 2022). Indian J Crit Care Med 2022. Inclusion: Articles compared the safety and efficacy of etomidate compared to k etamine, in patients of all age groups, as induction agents for RSI in the Emergency Department (ED) and prehospital settings. in the ketamine cohort compared to 12.4% in the etomidate cohort.

Outcomes 52

Outcomes Emergency Department Sepsis Operations 52

PEMBlog

AUGUST 20, 2024

Listen ECPR – PEM Currents: The Pediatric Emergency Medicine Podcast – by: Brad Sobolewski, MD, MEd [link] Subscribe Apple Podcasts Spotify YouTube References Gajkowski EF, Herrera G, Hatton L, et al. 2022; 68:133–152. Pediatric Emergency Care , 40(8), 618-622. These could include severe sepsis.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

RebelEM

OCTOBER 5, 2023

Background: Community-acquired pneumonia (CAP) can lead to pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and an increased risk of death. 2022) involving 586 ICU-admitted patients with severe community-acquired pneumonia (CAP), no benefit was observed from methylprednisolone administration.

Research 94

Research Outcomes Administration Shock 94

Northwestern EM Blog

MAY 16, 2022

1 Low-dose non-contrast abdominal CT has become the gold standard for diagnosis as it has become readily available in emergency departments nationwide, with some studies touting sensitivity and specificity of 97% and 95%, respectively.2 2022, May 16). were hospitalizations during f/u period; 26.4% References Fwu, C. Eggers, P.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9%

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

Taming the SRU

APRIL 13, 2023

2022 Pre-AeRATE Trial: use of HFNC for preoxygenation and apneic oxygenation showed no difference in lowest SpO2 during first intubation attempt when compared with usual care. Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. For more on “My Take” for a systematic approach to ECG interpretation — Please check out My Comment at the bottom of the page in the October 17, 2022 post in Dr. Smith’s ECG Blog.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

EMDocs

DECEMBER 18, 2023

Introduction Sepsis and septic shock are life-threatening conditions characterized by severe systemic inflammation and organ dysfunction due to a dysregulated host response to infection. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician.

Sepsis 91

Sepsis Fluid Resuscitation Resuscitation Shock 91

Broome Docs

JUNE 20, 2023

This episode covers herbs that may heal sepsis, drugs that probably don’t help in Covid, we ask: do steroids help in pneumonia? There are a lot of ideas to keep your brain up to date with the latest evidence in Emergency medicine. 2022 Aug;48(8):1009-1023. Epub 2022 May 13. Ann Emerg Med. Epub 2022 Oct 19.

Emergency Department 120

Emergency Department Sepsis Best Practices 120

ACEP Now

JANUARY 5, 2025

On June 24, 2022, Roe v. 1,2 This article reviews key statutes in the states with the strongest prohibitions against abortion and offers documentation principles for treating patients with ectopic pregnancies, spontaneous miscarriages, and other pregnancy-related emergencies. Wade was overturned by the U.S. South Dakota Statute: S.D.

Documentation/Coding 98

Documentation/Coding Sepsis Emergency Department 98

Taming the SRU

APRIL 26, 2023

Classification of sepsis, severe sepsis and septic shock: the impact of minor variations in data capture and definition of SIRS criteria. Evidence-Based Heatstroke Management in the Emergency Department. West J Emerg Med 2021. West J Emerg Med 2021. N Engl J Med 2022. Intensive Care Med 2012.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 52

Taming the SRU

SEPTEMBER 16, 2024

In the era of modern medicine, blood transfusions are commonplace, especially in the emergency department. While they are a lifesaving staple of medicine, they also come with risks that emergency providers must be aware of. 10, 19 May 2022, p. 2, July 2022, pp. 2859, [link] Afroz, Tamanna, et al.

Blood Transfusions 90

Blood Transfusions Anaphylaxis Emergency Department Sepsis 90

EMDocs

JULY 15, 2023

sepsis), immunocompromised patients, IV drug users, patients with prosthetic heart valves or any intravascular device Clinical features may not abe enough to differentiate erysipelas from cellulitis, and in such cases the treatment should be targeted towards cellulitis Labs No laboratory evaluation is required for the diagnosis of erysipelas.

EMS 92

EMS Infectious Diseases Shock Ultrasounds 92