PulmCCM

JUNE 3, 2024

Acetaminophen (paracetamol): Wikipedia Over the past 30 years, dozens of chemical compounds have been tested as therapies for sepsis. What if all the while, an effective sepsis treatment was hiding in plain sight right there on the PRN medication list?

Sepsis 52

Sepsis Outcomes Academics Hospitals 52

RebelEM

MAY 29, 2023

Background: Sepsis can induce numerous physiologic derangements. Crit Care 2023. Crit Care 2023. The Influence of Methylene Blue infusion on Cytokine Levels During Severe Sepsis. septic shock). Limited, small studies on its use in septic shock do not make a clear argument for use. Paper: Ibarra-Estrada, M et al.

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

Board Bombs

SEPTEMBER 10, 2023

We're covering what's important in sepsis care. Sepsis: burn the stopwatches. September 11th, 2023. We're covering what's important in sepsis care. Sepsis: burn the stopwatches. September 11th, 2023. Take a guess what we won't be covering. It begins with an L and ends in -actate. Accessed [date].

Burns 52

Burns Sepsis Administration Hospitals 52

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 109

Sepsis Emergency Department Outcomes Hospitals 109

PulmCCM

JANUARY 6, 2025

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

Sepsis Documentation/Coding Hospitals Outcomes 45

Board Bombs

OCTOBER 29, 2023

In the Spirit of Halloween let's cover Pediatric Sepsis- the tricks of the trade and how to not miss infections, as well as what to know for the test. Peds Sepsis: Nightmare on Epi Street. October 30th, 2023. Peds Sepsis: Nightmare on Epi Street. October 30th, 2023. Cite this podcast as: Briggs, Blake.

Sepsis 52

Sepsis Pediatrics Wellness 52

Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. In middle-to-high-income countries, after 40-60ml/kg of fluid resuscitation, the Surviving Sepsis Campaign International Guidelines recommend using vasoactive drugs. After 40ml/kg of IV 0.9% The CRT is unchanged.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

The Skeptics' Guide to EM

NOVEMBER 4, 2023

Time for paediatrics to screen out sepsis “screening.” June 2023 Date: Sept 12, 2023 Guest Skeptic: Dr. Damian Roland is a Consultant at the University of Leicester NHS Trust and Honorary Professor for the University of Leicester’s SAPPHIRE group. Time for paediatrics to screen out sepsis “screening.”

Sepsis 53

Sepsis Shock Hospitals 53

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., 2023 Mar;59(3):480-486 Who were the patients? This then leads to open the possibility of sepsis being missed when it is indeed present.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

Ken Grauer, MD

FEBRUARY 28, 2023

These 2 settings are: i ) In patients with severe , often longstanding pulmonary disease ; and / or , ii ) In acutely ill patients with multi-system disease ( ie, sepsis, shock, electrolyte and/or acid-base disorders ). MAT almost always occurs in one of 2 common predisposing settings. Additional material on MAT.

EKG/ECG 195

EKG/ECG Documentation/Coding Sepsis COPD 195

Pediatric EM Morsels

NOVEMBER 17, 2023

2023 Apr 28;24(3):579-587. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. 2022 Apr;29(4):406-414. doi: 10.1111/acem.14431. Paediatr Anaesth. 2018 Mar;28(3):210-217. doi: 10.1111/pan.13340. PMID: 29436138. West J Emerg Med.

Pediatrics 183

Pediatrics Emergency Department Outcomes Sepsis 183

EMDocs

APRIL 6, 2024

. #1: Phoenix Criteria – New Pediatric Sepsis Score Spoon Feed The Phoenix Sepsis Score, which is a novel clinical criterion for pediatric sepsis and septic shock developed using measures of organ dysfunction, outperforms existing IPSCC criteria for the diagnosis of pediatric sepsis and septic shock. 2023-062755.

Sepsis 76

Sepsis Pediatrics Shock 76

The Skeptics' Guide to EM

OCTOBER 14, 2023

March 2023 Date: July 12th, 2023 Guest Skeptic: Dr. Vicki Currie is a paediatric emergency medicine registrar in the West Midlands in the United Kingdom. March 2023 Date: July 12th, 2023 Guest Skeptic: Dr. Vicki Currie is a paediatric emergency medicine registrar in the West Midlands in the United Kingdom.

Pediatrics 87

Pediatrics Sepsis Urgent Care Emergency Department 87

Broome Docs

APRIL 6, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. 2023 Jan 21. 2023 Feb;64:206.e1-206.e3. 2023 Jan 30. 2023 Jan 13;76(2):185-191. 2023 Feb 03;: PMID: 36367144 Justin’s excellent critical appraisal and Full write up here. 2023 Feb;30(2):144-146. 2023 Mar 17;380:p601.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Don't Forget the Bubbles

JANUARY 1, 2024

Data from the Nurse-Family Partnership program involving 60,171 families were analysed across four cohorts, including pre-pandemic and three pandemic cohorts (from July 2022 to October 2023). 2023 Dec 22. 2023 Dec 21. 2023 Dec 19. 2023 Dec 12 Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

First 10 EM

APRIL 10, 2023

Apparently this paper was entirely fictional (or perhaps the […] The post Research Roundup (April 2023) appeared first on First10EM. Obviously the study was satire, and did an excellent job in making us laugh, but most satire studies (like those in the Christmas edition of the BMJ) are real studies.

Research 52

Research Sepsis Fractures EMS 52

EMDocs

JANUARY 11, 2025

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 72

EMS Sepsis Shock Fluid Resuscitation 72

PEMBlog

OCTOBER 18, 2023

rectally, prompting a sepsis workup given his age. 2023; 40( 2): 349- 351. Initially in the emergency department he was generally well-appearing with normal vital signs. His rash is pictured here: He subsequently developed a fever to 38.2C Labs were notable for: WBC 9.1 x 10E+09/L with ANC 4.46 Pediatr Dermatol. doi:10.1111/pde.15165

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

JournalFeed

DECEMBER 2, 2023

The JournalFeed podcast for the week of Nov 27th – Dec 1st, 2023. These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.

Sepsis 52

Sepsis Shock 52

Don't Forget the Bubbles

JULY 17, 2023

2023 Jun;38(6):1733-1751. 2023 May 16;28(3):172-183. 2023 Jun 6;28(4):205-251. 2023 Jun 6;28(4):252-266. 2023 Jun 1;177(6):559-560. 2023 Jun;182(6):2785-2792. 2023 May 16;28(3):184-202. Evaluating the Impact of the 2017 Dutch Neonatal Early-Onset Sepsis Guideline. 2023 Jun 15.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

Don't Forget the Bubbles

MAY 6, 2024

2024 Feb 28:fetalneonatal-2023-326501. doi: 10.1136/archdischild-2023-326501. Reviewed by: Tasnim Ransome and Spyridon Karageorgos Article 3: Which Sepsis Scoring Tools Perform Best? Organ Dysfunction in Children With Blood Culture-Proven Sepsis: Comparative Performance of Four Scores in a National Cohort Study.

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

Taming the SRU

AUGUST 30, 2023

Specific Evidence: Septic arthritis: According to the European Journal of Bone and Joint Infection’s 2023 guidelines for septic arthritis of native joints (SANJO), no blood tests have adequate sensitivity or specificity to either diagnose or exclude SANJO. 2023 Feb 2;388(5):439-452. Updated 2023 Apr 24]. 2023 Jul 10.

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

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. A Myriad of Infectious Disease Papers The use of steroids in severe sepsis remains challenging, primarily as proper patient selection is necessary to tease out those with the greatest likelihood of benefit.

Research 52

Research Airway Management Stroke Outcomes 52

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 66

Emergency Department Pediatrics Sepsis Resuscitation 66

Board Bombs

APRIL 30, 2023

April 30th, 2023. April 30th, 2023. Check out our interactive question bank podcast- the FIRST of its kind here: emrapidbombs.supercast.com. Cite this podcast as: Briggs, Blake; Husain, Iltifat. Episode 174. Cardiogenic Shock. link] Accessed [date] Hypotensive patient? Turns out, the heart could really care less. Episode 174.

Shock 52

Shock Sepsis 52

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

Taming the SRU

DECEMBER 17, 2024

There is substantial evidence that IV fluids can be beneficial in patients with sepsis complicated by hypotension and labor. Updated 2023 Oct 22]. Patients receiving maintenance fluids are hemodynamically stable, but they are unable to orally meet their daily fluid and electrolyte requirements. References Castera MR, Borhade MB.

Dehydration 82

Dehydration Fluid Resuscitation Administration Resuscitation 82

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. This post is part of the PEM Adventure at NEPTUNE 2023, hosted by Dani, Kat, Costas and Sarah. Brie-liiant!

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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 89

Stroke EMS EKG/ECG Radiology 89

EMDocs

JANUARY 20, 2025

2023 10 found that clinicians were 56% accurate in their assessments of patients admitted for heart failure when compared to the gold standard of blood volume measurement – a nuclear study utilizing radiolabeled red blood cells and albumin. 9 In terms of assessing volume status in general, Joseph et al. 11 A study by Stephan et al.

Dehydration 40

Dehydration Fluid Resuscitation Sepsis Resuscitation 40

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 Administration Emergency Department 98

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 88

Sepsis Best Practices Hospitals Outcomes 88

Don't Forget the Bubbles

NOVEMBER 18, 2024

Sepsis: This can induce widespread vasodilation and capillary leak, exacerbating hypotension. Blood Tests: Can help identify underlying causes such as infection (sepsis), anaemia, or electrolyte imbalances. Sepsis: The risk of sepsis increases after the first 24 hours, particularly in preterm infants. and Roberts, N.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

EM Literature of Note

OCTOBER 9, 2024

Before even considering the results, there are multiple fundamental considerations taking this published exploration into the realm of curiosity rather than insightfulness: This communication was submitted in Oct 2023 – meaning the LLMs used, while modern at the time, are debatably becoming obsolete. For what its worth, of course, U.S.

Radiology 86

Radiology Radiology Emergency Department Documentation/Coding 86

JournalFeed

OCTOBER 21, 2023

The JournalFeed podcast for the week of Oct 18-20, 2023. Friday 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.

Sepsis 52

Sepsis Resuscitation Outcomes 52

Don't Forget the Bubbles

MAY 31, 2023

2023 May 17:archdischild-2022-325280. We have a ringside view in the Children’s Emergency Department – the unique opportunity to see different types of acute presentations, whether DKA, sepsis or asthma, amongst a host of febrile children. D., & Paediatric Emergency Research United Kingdom and Ireland (PERUKI) (2023).

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

JournalFeed

MARCH 4, 2023

The JournalFeed podcast for the week of Feb 27 – Oct 3, 2023. Spoon Feed This unblinded superiority trial found no significant difference in mortality among patients who were randomized to a restrictive fluid strategy with earlier use of vasopressors or liberal fluid administration for treatment of sepsis-induced hypotension.

Sepsis 52

Sepsis Administration 52