ALiEM

FEBRUARY 9, 2024

The 2022 American College of Cardiology (ACC) pathway provides timely guidance [1]. Applying the 2022 ACC guideline Before delving into the specifics of the hs-cTn pathways, start with the ECG. The ACC 2022 pathway has a section dedicated to ECGs in ischemia [1], and FOAMcast has a great visual summary.

EKG/ECG 110

EKG/ECG Emergency Department Burns Wellness 110

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. Philadelphia, PA: Elsevier; 2022:1-11. 101,33 (2022): e30116. Updated 2022 Nov 14]. Curr Opin Hematol. 2017;24(1):46-53. doi:10.1097/MOH.0000000000000305

EMS 95

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 95

Don't Forget the Bubbles

MARCH 31, 2025

Reviewed by Dr Faye Leggott Article 2: Does fluid overload increase mortality in children with sepsis? Association between fluid overload and mortality in children with sepsis: a systematic review and meta-analysis. Sepsis is a significant cause of mortality in children, and fluid resuscitation is a key treatment strategy.

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

Pediatric EM Morsels

NOVEMBER 17, 2023

2022 May 11;10:864766. 2022 Apr;29(4):406-414. Epub 2022 Jan 12. Bibl K, Pracher L, Küng E, Wagner M, Roesner I, Berger A, Hermon M, Werther T. Incidence of Post-extubation Stridor in Infants With Cuffed vs. Uncuffed Endotracheal Tube: A Retrospective Cohort Analysis. Front Pediatr. doi: 10.3389/fped.2022.864766. 2022.864766.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

RebelEM

MAY 29, 2023

Background: Sepsis can induce numerous physiologic derangements. The Influence of Methylene Blue infusion on Cytokine Levels During Severe Sepsis. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e. septic shock).

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

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

The Trauma Pro

AUGUST 25, 2023

We have no idea if the numbers of T- and B-cells seen and the antibody titers are actually enough to avoid overwhelming post-splenectomy sepsis. Injury 53:3569-3574, 2022. Whether this is actually true is open to debate. But for now, it is probably okay to forgo the vaccines in patients undergoing angioembolization.

Sepsis 187

Sepsis Research Outcomes Hospitals 187

RebelEM

SEPTEMBER 21, 2023

Up to 80% of patients will have at least one troponin sent ( Gabrielli 2022 ). 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. Additionally, they found that up to 30% of the troponins sent are positive. Cardiol Rev.

EKG/ECG 143

EKG/ECG Sepsis EMS Outcomes 143

PulmCCM

DECEMBER 11, 2023

Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid bolus) led to similar outcomes as the usual practice of bolusing large volumes of fluids first. Either approach in severe sepsis with shock seems reasonable.

Sepsis 94

Sepsis Stroke Shock Infectious Diseases 94

EMDocs

NOVEMBER 7, 2023

Included patients had confirmed uncomplicated diverticulitis but no immunosuppression, peritonitis, sepsis. Patients with sepsis and immunocompromise were not included. Open-label, non-inferiority RCT including patients with uncomplicated diverticulitis, no significant comorbidities, no immunosuppression, and no signs of sepsis.

Sepsis 113

Sepsis Best Practices Hospitals Outcomes 113

JournalFeed

JANUARY 8, 2022

It’s the JournalFeed Podcast for the week of January 3-7, 2022. We cover POCUS for pyloric stenosis, deaths from OTC cough medicine in children, ED sepsis teams reduce mortality, dispo times early vs late in your shift, and new ASA 2022 difficult airway guidelines.

Sepsis 52

Sepsis 52

EMDocs

MARCH 4, 2025

Epub 2022 Dec 28. The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults [published correction appears in J Infect. Patients require admission. References: Pajor MJ, Long B, Koyfman A, Liang SY. Am J Emerg Med. 2023 Mar;65:76-83. PMID: 36592564.

Infectious Diseases 83

Infectious Diseases Seizures Poisoning Sepsis 83

EMDocs

JANUARY 9, 2024

Accessed August 28, 2022. Accessed August 25, 2022. Accessed August 28, 2022. McGraw Hill; 2022. Accessed August 27, 2022. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9e. McGraw Hill; 2020. link] Zafren K, Thurman R, Jones ID. Marine Dermatitis. In: Knoop KJ, Stack LB, Storrow AB, Thurman R.

Poisoning 105

Poisoning Burns Sepsis 105

Pediatric EM Morsels

APRIL 7, 2023

Unfortunately, it can cause so many other complications – Sepsis , acute chest syndrome , and hepatopathy. Updated 2022 Jul 18]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Atherosclerosis. 2013 Aug;229(2):496-503. doi: 10.1016/j.atherosclerosis.2013.05.006. 2013.05.006. Epub 2013 May 16. PMID: 23746538.

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

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

Don't Forget the Bubbles

MAY 31, 2023

2023 May 17:archdischild-2022-325280. doi: 10.1136/archdischild-2022-325280. in the Lancet Diabetes and Endocrinology 2022 , stated that an ‘ additional pronounced increase during the COVID-19 pandemic were general phenomena observed in most registries from different countries and continents.’ 2022 Nov 1;10(11):786-94.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

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

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

MARCH 4, 2024

Reviewed by: John Coveney Article 2: How do we define sepsis in children? International Consensus Criteria for Pediatric Sepsis and Septic Shock. The aim of this paper was to update and evaluate the criteria for sepsis and septic shock in children. It doesn’t help to diagnose or exclude sepsis. doi:10.1001/jama.2024.0179

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

EMDocs

JULY 1, 2023

UpToDate;2022. Accessed December 31, 2022. Accessed December 31, 2022. UpToDate;2022. Accessed December 31, 2022. UpToDate;2022. Accessed December 31, 2022. UpToDate;2022. Accessed December 31, 2022. In: Post TW, ed. link] Ramphul, K., Kawasaki disease: a comprehensive review.

EMS 92

EMS Infectious Diseases Pediatrics Research 92

RebelEM

OCTOBER 31, 2022

Vitamin C can function as an antioxidant and may mitigate endothelial oxidative stress in sepsis. Amrein 2018) A small, single-center, before-and-after study utilized a sepsis cocktail consisting of IV thiamine, hydrocortisone, and vitamin C and discovered a significant decrease in mortality compared to the control group.

Sepsis 52

Sepsis Outcomes Research Shock 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. 2022 Dec;57(12):986-993. Trials 23, 384 (2022). J Pediatr Surg. Kugler NW, Carver TW, Milia D, Paul JS.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Don't Forget the Bubbles

JUNE 19, 2023

Up To Date, [link] Accessed on: 11 August 2022. Prescriptive birthweight charts can improve the prediction of adverse outcomes in very preterm infants who are small for gestational age. Acta Pediatrica 2018;107:981-9. Infants with fetal (intrauterine) growth restriction. Roseboom T et al. Early Hum Dev 2006;82:485-91. Thornton PS et al.

Pediatrics 143

Pediatrics Ultrasounds Hyperthermia / Hypothermia Sepsis 143

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. 2018, Kuttab, Lykins et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Taming the SRU

AUGUST 30, 2023

A larger 2022 meta-analysis in the journal of Clinical Microbiology and Infection examined different test modalities for diagnosing pneumonia in the setting of clinical suspicion for acute community-acquired lower RTI in outpatient clinics, LTACs, and the emergency department. 2022 Jul 11;11(14):2163. days (secondary endpoint) [51].

Infectious Diseases 89

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

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

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. Date: July 16th, 2022 Reference: Lamontagne F et al. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. Guest Skeptic: Dr. Salim R. Guest Skeptic: Dr. Salim R.

Sepsis 40

Sepsis Shock Outcomes EMS 40

PulmCCM

MARCH 1, 2022

General topics include: sepsis, resuscitation, COVID and ventilation, advanced hemodynamics, advanced POCUS, with spotlights on nephrology, general surgery, POCUS for hospitalists and lots else. But this year offers much more than POCUS!

Ultrasounds 40

Ultrasounds Resuscitation Sepsis 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

Broome Docs

APRIL 6, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. 2022 Dec 16:emermed-2021-211946. Epub 2022 Nov 21. 2022 Jul 2;400(10345):39-47. 2022 Oct;51(10):595-604. 2022 Dec 20;328(23):2296. Epub 2022 Dec 7. N Engl J Med. 2023 Jan 21. doi: 10.1056/NEJMoa2212663. Epub ahead of print.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

The Skeptics' Guide to EM

JANUARY 15, 2022

Date: January 16th, 2022 Reference: Matchett, G. Date: January 16th, 2022 Reference: Matchett, G. Historically there has been concern about adrenal insufficiency caused by etomidate being harmful for patients with sepsis but this has not been shown to cause increased mortality in the literature [6, 7].

Sepsis 43

Sepsis Shock Emergency Department Outcomes 43

EMDocs

JULY 29, 2023

Emergency Medicine Residents’ Association; 2022. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Initial treatment is discontinuing medications that may reduce flow, oral hygiene, hydration, and hard or sour candies to promote flow. Rosh Review Website Link Further FOAMed: [link] [link] References: 1. 2004;97(11):1139.

EMS 96

EMS Dehydration Ultrasounds Emergency Department 96

EM Literature of Note

OCTOBER 20, 2022

Don’t forget the Annals of Emergency Medicine Podcast , a lighthearted feel-good romantic comedy with Rory Spiegel, available for free on your choice of streaming platforms: Apple Podcasts Google Podcasts Soundcloud Bimonthly #FOAMed in ACEPNow : Updates from the 2022 International Stroke Conference A skeptical look at new tools for diagnosing (..)

Stroke 40

Stroke Sepsis Pediatrics Resuscitation 40

ACEP Now

OCTOBER 30, 2023

Oftentimes, it can be an indication of pain, infection, distress, anxiety, dehydration, or the first sign of sepsis. 2022; 14: 441–456. The inverse is also true; what’s normal for most may be significantly abnormal for that patient and be the first red flag. One commonly used example is tachycardia. AEM Education Train. EM Resident.

Sexual Assault 98

Sexual Assault Teamwork Dehydration Outcomes 98

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. Discharging a patient with abnormal vital signs has been linked to unanticipated death (1-4).

Shock 105

Shock Emergency Department Pediatrics EKG/ECG 105

Mind The Bleep

AUGUST 5, 2023

Common signs and symptoms include: Abdominal distention with prominent veins and discolouration Umbilical flaring Poor feeding Bilious vomiting Abdominal tenderness Bowel changes, including diarrhoea, blood and mucus Lethargy, apnoea, bradycardia Sepsis Risk factors of low birth rate, prematurity and formula feeding. (1, Updated 2022 Aug 8].

Sepsis 52

Sepsis Ultrasounds Radiology Radiology 52

RebelEM

AUGUST 12, 2024

Epub 2022 Aug 28. Epub 2022 Aug 28. Intravenous amino acid therapy for kidney protection in cardiac surgery a protocol for a multi-centre randomized blinded placebo controlled clinical trial. The PROTECTION trial. Contemp Clin Trials. The PROTECTION trial. Contemp Clin Trials. PMID: 36038001 Levi TM, et al. Rev Bras Ter Intensiva.

Outcomes 81

Outcomes Hospitals Operations Shock 81