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 84

Dehydration Fluid Resuscitation Administration Resuscitation 84

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

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. 2023 Nov;7(1):e002094. doi: 10.1136/bmjpo-2023-002094. BMJ Paediatr Open. Whats it about? Am J Emerg Med.

Sepsis 59

Sepsis Fluid Resuscitation Shock Resuscitation 59

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

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

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

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

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

Dr. Smith's ECG Blog

JANUARY 2, 2025

She was managed for sepsis with antibiotics including azithromycin, had hypotension with arterial and central lines placed and pressors. I do not see OMI here and all trops were only minimally elevated, consistent with either chronic injury from cardiomyopathy or with acute injury from sepsis. She was intubated.

EKG/ECG 116

EKG/ECG Sepsis Wellness Documentation/Coding 116

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 98

Sepsis Pediatrics Shock 98

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

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

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 56

Sepsis Shock Hospitals 56

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

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 105

Pediatrics Sepsis Urgent Care Emergency Department 105

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

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. 0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. Updated 2023 Aug 23]. Curr Opin Hematol.

EMS 96

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 96

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

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

MARCH 4, 2025

2023 Mar;65:76-83. 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. Most often needed in patients with cryptococcal meningitis. Patients require admission. Am J Emerg Med. Epub 2022 Dec 28.

Infectious Diseases 85

Infectious Diseases Seizures Poisoning Sepsis 85

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 187

Pediatrics Emergency Department Outcomes Sepsis 187

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 94

Emergency Department Pediatrics Sepsis Resuscitation 94

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

EMDocs

NOVEMBER 25, 2023

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? Source Lower vs Higher Fluid Volumes in Adult Patients With Sepsis: An Updated Systematic Review With Meta-Analysis and Trial Sequential Analysis. 2023 Oct;164(4):892-912. Epub 2023 May 2.

Sepsis 72

Sepsis Emergency Department Pediatrics Academics 72

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

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

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 Pediatrics Outcomes 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 89

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

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 111

Stroke EMS EKG/ECG Radiology 111

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 114

Sepsis Best Practices Hospitals Outcomes 114

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

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

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

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

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

EMDocs

NOVEMBER 1, 2023

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.

Operations 95

Operations Radiology Radiology Fluid Resuscitation 95