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 17. 2023 Apr 25;329(16):1386-1398.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Broome Docs

SEPTEMBER 3, 2024

In a surprise to no one who reads First10EM, clinical judgment is better than all decision tools for sepsis Knack SKS, Scott N, Driver BE, Prekker ME, Black LP, Hopson C, Maruggi E, Kaus O, Tordsen W, Puskarich MA. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients.

Sepsis 95

Sepsis Emergency Department Outcomes Hospitals 95

EMDocs

OCTOBER 28, 2023

Spoon Feed Don’t hang your hat on lactate clearance to assess therapeutic response to resuscitation in sepsis; there are too many confounders, and initial clearance does not necessarily project clinical course. 2023 Sep;164(3):667-669. Epub 2023 Apr 20. #2: 2023 Aug 29;148(9):753-764. Epub 2023 Jul 13. #3:

Emergency Department 93

Emergency Department Pediatrics Sepsis Resuscitation 93

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. Updated 2023 Aug 23]. Gedefie, A.,

EMS 95

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 95

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., Time to change the reference ranges of children’s physiological observations in emergency care? Brennan et al. A prospective study.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

EMDocs

NOVEMBER 25, 2023

Source Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. 2023 Apr;98(4):620-627. Epub 2023 Feb 6. #2: 2023 Mar 30;110(4):432-438. 3: High or Low Fluid Volume in Sepsis?

Sepsis 70

Sepsis Emergency Department Pediatrics Academics 70

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. Annals of emergency medicine, 76(6), 788–800. Arch Dis Child. Why was the DIMPLES study needed?

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

ACEP Now

MAY 9, 2024

Complications of Gluteal AFT The pale, prone patient with multiple surgical drains and a constrictive faja has become a common site in the Jackson Memorial Hospital Emergency Department. Nearly half of all post-AFT patients presenting to our emergency departments required admission and six percent required ICU admission.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 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

Broome Docs

APRIL 6, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. 2023 Jan 21. Am J Emerg Med. 2023 Feb;64:206.e1-206.e3. 2023 Jan 30. A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments. 2023 Jan 13;76(2):185-191. Acad Emerg Med.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

AENJ: Current Issue

MAY 8, 2024

This column on translating research into practice is crafted to offer advanced practice registered nurses an analysis of current research topics that hold practical relevance for emergency care settings.

Emergency Department 40

Emergency Department Outcomes Sepsis Research 40

EM Literature of Note

OCTOBER 9, 2024

This exploration of LLMs in the emergency department is a bit unique in its conceptualization. emergency departments are general cesspools of aggressive empiric antibiotic coverage, driven by CMS regulations – so it may in fact be the LLM displaying astute clinical judgement, here. For what its worth, of course, U.S.

Radiology 86

Radiology Radiology Emergency Department Documentation/Coding 86

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

EB Medicine

JANUARY 3, 2023

2) 2023 E/M coding guidelines are in effect. 2) 2023 E/M coding guidelines are in effect. Announcements: 1) The interactive Clinical Pathways have launched and they are available for free!

Shock 52

Shock Pediatrics Airway Management Sepsis 52

PEMBlog

OCTOBER 18, 2023

Initially in the emergency department he was generally well-appearing with normal vital signs. rectally, prompting a sepsis workup given his age. 2023; 40( 2): 349- 351. She did have a remote history of oral cold sores but no recent lesions. His rash is pictured here: He subsequently developed a fever to 38.2C

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

Don't Forget the Bubbles

MAY 6, 2024

Factors that impact second attempt success for neonatal intubation following first attempt failure: a report from the National Emergency Airway Registry for Neonates. 2024 Feb 28:fetalneonatal-2023-326501. doi: 10.1136/archdischild-2023-326501. Each patient was scored using the four sepsis tools. Epub ahead of print.

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

Dr. Smith's ECG Blog

OCTOBER 20, 2024

sepsis, anemia, hypoxemia, severe hypotension etc., The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization. And although severe underlying coronary disease is often the cause — non-coronary causes may be seen ( See My Comment in the March 1, 2023 post for the common causes of DSI ).

EKG/ECG 128

EKG/ECG Shock Emergency Department Ambulance Services 128

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. Reference article, Radiopaedia.org (Accessed on 28 Aug 2023) [link] Ortiz de Mendivil A, Alcalá-Galiano A, et al. Updated 2023 Jun 24]. Updated 2023 Aug 28].

Stroke 110

Stroke EMS EKG/ECG Radiology 110

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

ACEP Now

MAY 10, 2024

Patients with flank pain (which would suggest pyelonephritis) as well as patients meeting two or more SIRS criteria (which would suggest sepsis) comprise a higher risk group. Published online 2023. For simplicity, we will focus only on the patients with suspected lower urinary tract infection (UTI). New England Journal of Medicine.

Infectious Diseases 98

Infectious Diseases Sepsis Emergency Department Administration 98

RebelEM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. appeared first on REBEL EM - Emergency Medicine Blog. Click here for Direct Download of the Podcast Paper: Knack SKS et al. Range 5 to 9) Etomidate: 7.0

Outcomes 98

Outcomes Emergency Department Administration Resuscitation 98

ACEP Now

MARCH 6, 2024

The Sisyphean task remains to try to keep up—and, in that vein—here is a light round of the emergency medicine literature from 2023. 7 The operators involved in the trial were mostly emergency medicine residents or critical care fellows, but this fact does not diminish the generalizability of these observations. percent to 38.3

Research 52

Research Airway Management Stroke Outcomes 52

EMDocs

NOVEMBER 27, 2023

A 55-year-old male, with a previous medical history of hypertension, hyperlipidemia, and gout, presents to the emergency department for four days of fever and progressive rash. McGraw-Hill Education; 2023. This series provides evidence-based updates to previous posts so you can stay current with what you need to know.

EMS 96

EMS Sepsis Burns EKG/ECG 96

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today. Surg Neurol Int.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

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

Don't Forget the Bubbles

MAY 8, 2024

2024 Apr 25:archdischild-2023-326533. A silent scream in the pediatric emergency department: child abuse and neglect. 2024 Apr 18:fetalneonatal-2023-326679. 2024 Apr 16:archdischild-2023-326247. 2024 Apr 16:archdischild-2023-326331. 2024 Apr 8:archdischild-2023-326175. JAMA Pediatr. Wong J, et al.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

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. Accessed March 27, 2023. Emergency Medicine Residents’ Association; 2022. Accessed on April 11, 2023. RR 18, SpO2 97% on RA.

EMS 96

EMS Dehydration Ultrasounds Emergency Department 96

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. N Engl J Med.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. Complications of acute gallbladder perforation include localized peritonitis, hepatic, subhepatic, or pelvic abscess formation, pneumonia, pancreatitis, acute renal failure, and sepsis (7). Indian J Surg.

Ultrasounds 79

Ultrasounds Sepsis Radiology Radiology 79

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. Lancet 2011;377:2023-30. 2023 Aug;38(11):2593-2606. Epub 2023 Apr 19. PMID: 20133929 Meijvis SCA, Hardeman H, Remmelts HHF, et al.

Research 94

Research Outcomes Administration Shock 94

PEMBlog

MARCH 27, 2024

This episode will help you better prepare for and manage children with inborn errors of metabolism in the Emergency Department. Updated 2023 Jul 17]. Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

ACEP Now

OCTOBER 10, 2023

A 76-year-old female presents to the emergency department obtunded with left hemiplegia. External Validity: It is unclear if this data applies to patient you see in your emergency department. Accessed September 17, 2023. Accessed September 17, 2023. Symptoms began just prior to presentation. EMCrit website.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

PEMBlog

AUGUST 20, 2024

2023; 187:109792. Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEMCurrents, the Pediatric Emergency Medicine Podcast. These could include severe sepsis. Rationale and methods of the advanced R2Eperfusion STrategies for refractory cardiac ARREST (ARREST) trial. Am Heart J.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

Don't Forget the Bubbles

NOVEMBER 1, 2023

This month, Bubble Wrap has teamed up with Sheffield Children’s Hospital Emergency Department to have a look at what’s new in paediatric literature. Emergency Medicine Journal 2023; 40: 583-587. Lactate as a screening tool for critical illness in a pediatric emergency department. What’s it about?

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

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

So we are planning to take this show on th eraod and do some live sessions later in 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.

Emergency Department 120

Emergency Department Sepsis Best Practices 120

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. April 26, 2023) Acute Hyperthermia in the Emergency Department.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Emergency Department Stroke Sepsis 52