Emergency Medicine Cases

MAY 5, 2020

The post EM Quick Hits 18 Conservative Management Pneumothorax, Microdosing Buprenorphine, Practical Use of CRITOE, Canadian TIA Score, Pediatric Surviving Sepsis Guidelines, Safety of Peripheral Vasopressors appeared first on Emergency Medicine Cases.

Sepsis 52

Sepsis Pediatrics EMS Fractures 52

EMDocs

JULY 1, 2023

We’ll keep it short, while you keep that EM brain sharp. This is the only situation in which aspirin is recommended for administration in children, as the benefits outweigh the risks of Reye syndrome. link] The post EM@3AM: Kawasaki Disease appeared first on emDOCs.net - Emergency Medicine Education. Lakhani, N. UpToDate;2022.

EMS 84

EMS Infectious Diseases Pediatrics Research 84

PHEM Cast

APRIL 10, 2016

[link] We hope you enjoyed our sepsis podcast. St Emlyns Induction podcast on Sepsis. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. March 2016.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

RebelEM

APRIL 26, 2023

Remember to evaluate for concurrent medical illness: gastritis, pancreatitis, pyelonephritis, pneumonia, sepsis. Thiamine 100mg IV 4 Fix electrolyte abnormalities (Hypokalemia, Hypomagnesemia) Administration of bicarbonate is generally unnecessary. Treatment consists of thiamine, dextrose, and volume repletion. 1991 Aug;91(2):119-28.

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Sepsis Administration EMS 127

EMDocs

SEPTEMBER 6, 2023

Learning points: Consider differential – sepsis, thyroid storm, thalamic stroke, exertional and classic heat stroke, serotonin syndrome, neuroleptic malignant syndrome, sympathomimetic toxicity, and anticholinergics. Reference: EM@3AM – Heat Stroke Case 2: 40-year-0ld female feels unwell but no other specific complaints.

Anaphylaxis 90

Anaphylaxis Shock Sepsis Stroke 90

The Skeptics' Guide to EM

FEBRUARY 17, 2018

Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. Case: EMS is dispatched to a retirement […] The post SGEM#207: Ahh (Don’t) Push It – Pre-Hospital IV Antibiotics for Sepsis. Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial.

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

EMDocs

AUGUST 17, 2023

The study was performed when Surviving Sepsis Campaign Guidelines were used, so it was more common to see large volume fluid administration in the setting of sepsis. Welcome back to the “52 in 52” series. This collection of posts features recently published must-know articles. Today we look at the CENSER trial.

Sepsis 86

Sepsis Shock Resuscitation Fluid Resuscitation 86

Critical Care Now

AUGUST 18, 2024

ClinicalTrials.gov: NCT025174897 Background: Community-acquired pneumonia (CAP) can lead to significant pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and increased mortality. Check out the full post on REBEL EM: [link] New guidelines from SCCM strongly support its use.

Outcomes 93

Outcomes Sepsis Administration EMS 93

EMDocs

NOVEMBER 27, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

EMS 91

EMS Sepsis Burns EKG/ECG 91

EMDocs

NOVEMBER 1, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

Operations 86

Operations Radiology Radiology Fluid Resuscitation 86

The Skeptics' Guide to EM

FEBRUARY 23, 2019

Association Between Early Intravenous Fluids Provided by Paramedics and Subsequent In-Hospital Mortality Among Patients With Sepsis. Association Between Early Intravenous Fluids Provided by Paramedics and Subsequent In-Hospital Mortality Among Patients With Sepsis. Date: February 22nd, 2019 Reference: Lane et al. Reference: Lane et al.

Sepsis 52

Sepsis Administration Documentation/Coding Hospitals 52

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. Range 5 to 9) Etomidate: 7.0 Range 5 to 9) Diff -0.2; 95% CI -1.4 Read more

Outcomes 93

Outcomes Emergency Department Administration Resuscitation 93

The Skeptics' Guide to EM

JUNE 6, 2020

Max is then going to Georgetown to be an attending in both EM and ICU. Background: I think we have covered sepsis more often than any other topic on the SGEM. Significant effort has been placed on the administration of IV crystalloids to address concerns for hypovolemia in septic shock.

Sepsis 52

Sepsis Shock Resuscitation Administration 52

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. We have a special episode for you this month… We’ve brought Dr. Jeremy Rose, one of the peer reviewers, and a sepsis expert, on with us to talk through the content this month. Jeff : Sepsis chair. Sepsis-3!!

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

The Skeptics' Guide to EM

JANUARY 25, 2020

Case: A 60-year-old male is […] The post SGEM#281: EM Docs Got an AmbuBag – The PreVent Trial first appeared on The Skeptics Guide to Emergency Medicine. Case: A 60-year-old male is in your emergency department with sepsis from pneumonia. Date: January 9th, 2020 Reference: Casey et al. Reference: Casey et al.

EMS 40

EMS Airway Management Administration Resuscitation 40

RebelEM

JANUARY 29, 2024

PMID: 37188358 Clinical Question: What is the efficacy and safety of low-dose (25mg) prolonged administration (over 6hrs) of alteplase in patients with massive PE? appeared first on REBEL EM - Emergency Medicine Blog. Reduced-Dose Systemic Fibrinolysis in Massive Pulmonary Embolism: A Pilot Study. Clin Exp Emerg Med 2023.

Stroke 133

Stroke Outcomes Hospitals Administration 133

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? Hegeman EM, et al. Schwindt EM, et al. 2023 Apr 18.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

EMDocs

OCTOBER 25, 2024

ESR & CRP – nonspecific and typically elevated Blood culture – if presenting with sepsis Imaging: Consider a chest radiograph in patients with pulmonary symptoms to evaluate for associated pneumonitis, pleural effusions, cardiomegaly. DRESS Syndrome has a 10% mortality rate with the primary cause of mortality being hepatic necrosis.

Sepsis 91

Sepsis Burns EKG/ECG EMS 91

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. 2022) involving 586 ICU-admitted patients with severe community-acquired pneumonia (CAP), no benefit was observed from methylprednisolone administration.

Research 94

Research Outcomes Administration Shock 94

Emergency Medicine Ireland

JANUARY 22, 2024

It’s clear that the features listed above are fairly non specific and like always it’s likely just sepsis. There may well be some co existing sepsis so give some antibiotics. Reading: Oh Chapter 61 Tasty Morsels of EM 130 The IBCC Deranged Physiology Welcome back to the tasty morsels of critical care podcast.

Sepsis 52

Sepsis Resuscitation Wellness Administration 52

RebelEM

FEBRUARY 2, 2023

This could have biased the results in favor of amiodarone as we’ve covered this before on REBEL EM before The IV amiodarone group required less additional HR control agents to control increased heart rate. Sepsis, hyperthyroidism, dehydration, heart failure, ACS, etc). Therefore, no definitive conclusions can be made about this trial.

Emergency Department 52

Emergency Department Administration Dehydration EMS 52

Northwestern EM Blog

JANUARY 24, 2022

And for most forms, EM physicians are not typically shocked by shock. Acidosis Acidosis in shock states can present from multiple different sources, including sepsis, hypoxemia, ingestions, hyperlactatemia from hypoperfusion, amongst others. Hypothyroidism and Adrenal Insufficiency in Sepsis and Hemorrhagic Shock. 3) Farkas J.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

The Skeptics' Guide to EM

OCTOBER 3, 2021

Case: A 66-year-old woman is brought in by EMS from home with lethargy and hypotension. Clinical Question: Does administration of a balanced solution (Plasma-Lyte 148) during intensive care unit (ICU) stay, compared with saline solution, result in improved 90-day survival in critically ill patients?

Outcomes 52

Outcomes Sepsis Administration Resuscitation 52

The Skeptics' Guide to EM

FEBRUARY 24, 2018

He writes an excellent blog called EM Nerd , which he describes as nihilistic ramblings. There was also the HYPRESS trial that we reviewed on SGEM#168 with Salim Rezaie from REBEL EM. This looked at hydrocortisone to prevent patients with severe sepsis in developing septic shock.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. 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. The below ECG was recorded.

EKG/ECG 132

EKG/ECG Shock Hospitals Sepsis 132

RebelEM

AUGUST 12, 2024

PMID: 36038001 Clinical Question: In patients undergoing cardiac surgery with cardiopulmonary bypass, does the administration of intravenous amino acid therapy lead to lower occurrence of postoperative AKI when compared to placebo? The PROTECTION trial. Contemp Clin Trials. Epub 2022 Aug 28.

Outcomes 81

Outcomes Hospitals Operations Shock 81

EB Medicine

JANUARY 10, 2020

This can be the result of hypotension, tachycardia, sepsis, PE, etc. PCI) in STEMI Early administration of aspirin decreases mortality and complications of MI (all types). (19), This can be the result of hypotension, tachycardia, sepsis, PE, etc. Part 4: Pre-hospital care Prehospital ECGs decrease time to intervention.

Emergency Department 40

Emergency Department Shock EKG/ECG Sepsis 40

RebelEM

JANUARY 25, 2023

Rezaie, MD (Twitter: @srrezaie ) The post REBEL Core Cast 94.0 – SBO appeared first on REBEL EM - Emergency Medicine Blog. Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

ACEP Now

JULY 7, 2023

Patients with sepsis get antibiotics. First, oral administration is preferred, as this route can often be as effective as intramuscular administration. Wilson MP, Chen N, Vilke GM, Castillo EM, MacDonald KS, Minassian A. This month, we are discussing the medical management of patients with mild to moderate agitation.

Emergency Department 52

Emergency Department Psychiatric Administration Best Practices 52

ACEP Now

MARCH 6, 2024

Gotta catch ‘em all!” The PATCH-Trauma trial took a critical look at TXA in major trauma in the advanced trauma systems of Australia and found a mixed result: a slightly greater number of patients were still alive six months following TXA administration, but there was no difference in survival with a good functional outcome.

Research 52

Research Airway Management Stroke Outcomes 52

Northwestern EM Blog

MAY 16, 2022

Finally, a burden on us as EM clinicians is training in and awareness of clinical practice guidelines and recommendations from specialties outside of EM. were hospitalizations during f/u period; 26.4% Please ensure that you document and discuss with the patient accordingly. J Urol 2019. 202(3):475-483.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

EM Updates

JUNE 15, 2021

Administrative logistics demanded that patients receiving ongoing care in the emergency department be formally admitted to the hospital; we were therefore enjoined to admit these patients to ourselves and therefore formed the Emergency Department Admitting Team. Severe Covid-19 [published online ahead of print, 2020 May 15]. N Engl J Med.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

EMDocs

DECEMBER 18, 2023

Today, she would not get out of bed, prompting the facility to call EMS. 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. The patient currently resides at a skilled nursing facility.

Sepsis 83

Sepsis Fluid Resuscitation Resuscitation Shock 83

EB Medicine

SEPTEMBER 1, 2018

If EMS has placed bandages, leave them in place until antivenom and resuscitative equipment is ready. Unfortunately, this myokymia may not respond to antivenom administration and myokymia of the chest well and torso can necessitate intubation in extreme cases. Talk to you soon Most Important References 4.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

RebelEM

MAY 15, 2024

Early administration of antibiotics is the only factor known to reduce this mortality. Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. Early administration of antibiotics is the only factor known to reduce this mortality. Isolate, but do not wait to initiate treatment.

Infectious Diseases 90

Infectious Diseases Administration Sepsis Anaphylaxis 90

RebelEM

NOVEMBER 11, 2024

Background: Patients with sepsis are routinely treated with empiric broad-spectrum antibiotics while awaiting source identification, as recommended by the surviving sepsis campaign.2 Mortality of Patients With Sepsis Administered Piperacillin-Tazobactam vs Cefepime. In 2021, Buckley et. 3 The same year, Ross et. JAMA Intern Med.

Sepsis 101

Sepsis Outcomes Administration Shock 101

EMDocs

FEBRUARY 8, 2025

Well keep it short, while you keep that EM brain sharp. Routine versus selective antifungal administration for control of fungal infections in patients with cancer. The post EM@3AM: High Priority Fungal Pathogens and Empiric Treatment in the ED appeared first on emDOCs.net - Emergency Medicine Education. 2017;44(6):276-278.

Infectious Diseases 65

Infectious Diseases EMS COPD Research 65