Thinking Critical Care

MARCH 18, 2024

So, while waiting for HR25 (May 2025), Katie once again worked her magic to put together a one-day webinar that packs a academic and clinical punch. Preliminary Schedule: H&R 2024 Outline: Acute Inpatient Medicine – Next Level! Date: June 15 10am-4:30pm EST (7am-1:30pm PST) Format: one-day, 6.5

Shock 63

Shock Sepsis Academics 63

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

ALiEM

SEPTEMBER 9, 2024

Patients are at high risk of bacterial spread to the abdomen or retrograde spread up the ventriculoperitoneal shunt leading to peritonitis, peritoneal abscess, ventriculitis, meningitis, or sepsis. Further indicated invasive/surgical interventions should be deferred to general surgery and neurosurgery consultants. Surg Neurol Int.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

Taming the SRU

AUGUST 30, 2023

A 2011 meta-analysis in the journal of Academic Emergency Medicine found ESR, CRP, and PCT were not acutely useful in the diagnosis of septic arthritis due to wildly varying sensitivities and specificities between studies. 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

Taming the SRU

JULY 24, 2023

General surgery was consulted, and given the patient's significant comorbidities, he was transferred to a tertiary care academic center for further evaluation and management. In those with concern for sepsis, blood cultures, broad spectrum IV antibiotics and fluids should be given as needed. coli and rare budding yeasts.

Ultrasounds 79

Ultrasounds Sepsis Radiology Radiology 79

Northwestern EM Blog

MARCH 1, 2025

There are several etiologies including viral pneumonia, bacterial pneumonia, sepsis, trauma, and pancreatitis. Academic Emergency Medicine. Blog Post References Caputo, N.D., Strayer, R.J., Levitan, R. Early self-proning in awake, non-intubated patients in the emergency department: a single EDs experience during the COVID-19 pandemic.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

The Skeptics' Guide to EM

DECEMBER 11, 2021

Back in 2019 we were talking about Vitamin C for sepsis ( SGEM#268 ). There have been at least two randomized control trials published that do not support the use of Vitamin C in sepsis. It was Dr. Paul Marik who has been a big advocate for Vitamin C sepsis. Not much has changed over the last two years.

Sepsis 40

Sepsis Shock Outcomes Academics 40

PulmCCM

DECEMBER 10, 2023

Over the years, dozens of copycat studies (which are relatively easy for academics to churn out) created a steady, low-quality drumbeat of negativity toward Zosyn. Zosyn seems to have been cleared of all renal wrongdoing and to have won this round against cefepime.

Seizures 52

Seizures Sepsis Academics Administration 52

Dr. Smith's ECG Blog

JULY 21, 2024

The stay in the cardiac intensive care unit (CICU) was further complicated by sepsis, delirium, GI bleeding, and anuric renal failure with need for renal replacement therapy. Distinction of PMVT vs VFib is an academic one in this case ). The arrhythmia starts with a PVC having a short coupling interval.

EKG/ECG 132

EKG/ECG Shock Hospitals Sepsis 132

RebelEM

MARCH 27, 2023

What They Did: Retrospective, observational cohort study in a single high-volume academic hospital The ED had a 5 bed area used for ongoing management and resuscitation of patients who clinically deteriorate while boarding or while actively undergo a workup in other sections of the ED. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

RebelEM

FEBRUARY 2, 2023

Sepsis, hyperthyroidism, dehydration, heart failure, ACS, etc). PMID: 36115743 Clinical Question: What is the effectiveness of IV amiodarone vs IV digoxin used as second line therapy in critically ill emergency department patients with atrial fibrillation/flutter where first-line BB use has failed?

Emergency Department 52

Emergency Department Administration Dehydration EMS 52

EB Medicine

JULY 8, 2019

Jeff: And while it’s not exactly core EM, we’re going to briefly discuss indications for bariatric surgery, as this is something we don’t often review even in academic training programs. Some may present with isolated tachycardia while others may present with profound sepsis – tachycardia, hypotension, and fever. At 6 to 8 mL/kg.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Dr. Smith's ECG Blog

JANUARY 5, 2020

MAT almost always occurs in one of 2 common clinical scenarios : i ) Severe pulmonary disease ( ie, COPD, long-term asthma; pulmonary hypertension ) ; or , ii ) Acutely ill patients with multisystem disease ( ie, patients with sepsis; shock; electrolyte and/or acid-base disorders ).

EKG/ECG 52

EKG/ECG COPD Wellness Sepsis 52

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC. N Engl J Med.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

EMDocs

NOVEMBER 25, 2023

3: High or Low Fluid Volume in Sepsis? New Meta-analysis Spoon Feed This updated systematic review and meta-analysis showed no statistically significant difference in all-cause mortality or serious adverse events in sepsis patients given low vs higher fluid volumes. Clay Smith at @spoonfedEM , and sign up for email updates here. #1:

Sepsis 63

Sepsis Emergency Department Pediatrics Academics 63

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This is true in life-threatening conditions such as sepsis. However, when children do not have features of sepsis, oral antibiotics are equally effective. The take home is that although IV antibiotics are key in sepsis management, oral antibiotics are equally as effective as IV antibiotics for children without critical illness.

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

Don't Forget the Bubbles

FEBRUARY 24, 2025

Because of this possible diagnosis, they were commenced on a macrolide antibiotic (azithromycin) in addition to treatment for neonatal sepsis +/- meningitis (ceftriaxone and acyclovir). Embracing plain language over academic formality doesn’t diminish the profession’s rigour; instead, it reinforces our fundamental purpose.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

Taming the SRU

OCTOBER 31, 2024

Ann Emerg Med 2024; Big Picture Current screening tools for pediatric septic shock and sepsis are highly specific but lack sensitivity. This study substituted age adjusted vital sign measures and a pediatric shock index into currently existing pediatric sepsis scoring systems to create the qPS4.When

Sepsis 72

Sepsis Shock Pediatrics Administration 72

The Skeptics' Guide to EM

NOVEMBER 23, 2024

Academic Emergency Medicine. If left untreated, the appendix may rupture, leading to peritonitis, abscess formation, or sepsis, which significantly increases morbidity. Date: November 13, 2024 Reference: Lee WH, et al. Study of Pediatric Appendicitis Scores and Management Strategies: A Prospective Observational Feasibility Study.

Pediatrics 77

Pediatrics Sepsis Academics Emergency Department 77

Emergency Medicine Journal

FEBRUARY 21, 2025

Methods We conducted a prospective observational study of adult and paediatric patients who suffered cardiac arrest in an academic hospital ED in central Haiti from January 2019 to August 2020. Patients were identified prospectively at the time of clinical care. Results We identified 161 patients who suffered cardiac arrest in the ED.

Outcomes 40

Outcomes Emergency Department Sepsis Academics 40

Taming the SRU

JUNE 6, 2023

mg/kg of IBW Seek to match a patient's minute ventilation with TV and RR after intubation Intentionally match patient's intrinsic RR noted prior to intubation Note that healthy lungs can handle 8 mL/kg, based on IBW, if that is useful for compensation Secure your ETT Thomas Tube Holder is a new ETT holder on Air Care for ETT down to size 6.5

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Taming the SRU

FEBRUARY 3, 2025

Academic Press; 2014:39-64. paclitaxel, doxorubicin, cisplatin) high-risk monoclonal antibody treatments (i.e. TamingtheSRU. www.tamingthesru.com/blog/diagnostics/tumor-lysis-syndrome. References 1. Howard SC, Pui CH, Ribeiro RC. Chapter 4 - Tumor Lysis Syndrome. In: Finkel KW, Howard SC, eds. Renal Disease in Cancer Patients.

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56

PulmCCM

OCTOBER 23, 2023

Over the years, dozens of copycat studies (which are relatively easy for academics to churn out) created a steady, low-quality drumbeat of negativity toward Zosyn. Zosyn seems to have been cleared of all renal wrongdoing and to have won this round against cefepime.

Hospitals 98

Hospitals COPD Emergency Department CDC 98

Sensible Medicine

DECEMBER 31, 2024

He developed sepsis very similar to puerperal fever and died. Given the similarities between the way his friend died and death from puerperal fever, Semmelweis thought that there must be some pathogen transmitted by dead tissue causing sepsis. A friend of Semmelweis cut his finger during an autopsy. He died in an asylum.

Sepsis 145

Sepsis CDC Burns Academics 145

Mind The Bleep

NOVEMBER 20, 2024

On one hand, ID specialists may need to provide rapid, critical input to guide sepsis management or advise other specialties in urgent situations. Here’s how it works: Points-Based Long listing Candidates are scored on a variety of criteria, such as academic achievements, clinical experience, and additional qualifications.

Infectious Diseases 52

Infectious Diseases Research Patient Safety Sepsis 52