Remove 2023 Remove Fluid Resuscitation Remove Sepsis
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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. So, fluid has been tried but has not got close to fixing the problem. The Surviving Sepsis Campaign International Guidelines recommend either adrenaline or noradrenaline as the first-line inotrope.

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EM@3AM: ESBL-Producing Organisms and Their Management

EMDocs

8 Workup and Diagnosis Evaluation should be tailored to the patient presentation, but may include studies such as: CBC, CMP, UA, lactate (if concern for sepsis), Cultures (blood, urine, etc.) IV fluid resuscitation as needed. Therefore, his presentation is most consistent with sepsis due to acute complicated UTI.

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Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

RebelEM

For those with sepsis, the administration of intravenous fluids (IVF) at the volumes recommended in the Surviving Sepsis Campaign (SSC) requires careful consideration of an individual’s chronic medical conditions and subsequent sensitivity to IVF. Studies without a clear timeframe for fluid administration.

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EM@3AM: Amniotic Fluid Embolism

EMDocs

Amniotic fluid embolism: a reappraisal. 2023 Dec 13;52(2):126-135. doi: 10.1515/jpm-2023-0365. “Amniotic fluid embolism.” “Amniotic fluid embolism: diagnosis and management.” “Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation.”

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emDOCs Revamp: Esophageal Perforation

EMDocs

1 , 4 If presenting later in course or with an intra-abdominal perforation, patients are more likely to show signs of sepsis and hemodynamic instability. VBG with lactate 4 – may show low pH with elevated lactate Cardiac biomarkers – to evaluate for cardiac etiology in those presenting with chest pain or type II NSTEMI in those with sepsis.

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Bubble Wrap PLUS – July 2024

Don't Forget the Bubbles

2023 Oct 16;29(3):171-173. Trends in C-Reactive Protein Use in Early-Onset Sepsis Evaluations and Associated Antibiotic Use. 2024 Jun 26:fetalneonatal-2023-326691. Fluid resuscitation in children with severe infection and septic shock: a systematic review and meta-analysis. Barlabà A, et al. Eur J Pediatr.

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The CLOVERS Trial

Taming the SRU

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. 2021, Im, Kang et al.

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