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emDOCs Podcast – Episode 85: Tricky Cases Part 1

EMDocs

Learning points: Consider differential – sepsis, thyroid storm, thalamic stroke, exertional and classic heat stroke, serotonin syndrome, neuroleptic malignant syndrome, sympathomimetic toxicity, and anticholinergics. Temperature starts to decrease. Removed from cooling at 102 and admitted to ICU. Complete primary and secondary survey.

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Vasopressor Nonresponse

Northwestern EM Blog

Acidosis Acidosis in shock states can present from multiple different sources, including sepsis, hypoxemia, ingestions, hyperlactatemia from hypoperfusion, amongst others. Anaphylaxis Anaphylaxis may present as hypotension alone. Hypothyroidism and Adrenal Insufficiency in Sepsis and Hemorrhagic Shock. 2008;14:379-83.

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Review of the ATHOS 3 trial

Northwestern EM Blog

This data shows us that angiotensin II can make the blood pressure better but I would never let it distract you from the things we know matter in sepsis resuscitation.

Shock 52
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Approach to Shock

Pediatric Emergency Playbook

Distributive Shock The most common cause of distributive shock is sepsis, followed by anaphylactic, toxicologic, adrenal, and neurogenic causes. Children with sepsis come in two varieties: warm shock and cold shock. If so, treat the cause – perhaps this is a distributive problem due to anaphylaxis. Treat with epinephrine.

Shock 40
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Grand Rounds Recap 4.19.23

Taming the SRU

EMS was bagging him on arrival Primary notable for Compromised Airway Protection, bilateral Breath sounds, strong pulses,GCS 3 CT images of Head, Chest, Abdomen, Pelvis, and Spine No acute findings pH of 6.75

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Episode 20 - Emergency Department Management of North American Snake Envenomations

EB Medicine

Jeff: Hypotension should be treated with isotonic fluids and, as usual, anaphylaxis should be treated with the usual cocktail of antihistamines and epinephrine at first IM and then via infusion if refractory. Note that antivenom will NOT reverse anaphylaxis on its own. Regardless, the treatment is the same – epinephrine.

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Diagnostics: Blood Transfusion Reactions

Taming the SRU

Mild Reactions Transfusion Reaction Frequency Timeline Presentation Management Allergic - 1-3% with platelet and plasma components - 0.1-0.3%