EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. For those listening, my hospital probably looks a little bit like yours. Roughly half of in-hospital mortality is associated with septic in some fashion. At our hospital in northern Manhattan they like to breath around 18.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

PHEM Cast

FEBRUARY 23, 2017

Prehospital Blood Product Resuscitation for Trauma. Shorter times to packed red blood cell transfusion are associated with decreased risk of death in traumatically injured patients. Prehospital transfusion of plasma and red blood cells in trauma patients. Lots to think about! 2016 Jul;46(1):3–16.

Blood Transfusions 52

Blood Transfusions Head Injuries Resuscitation Radiology 52

RebelEM

SEPTEMBER 26, 2022

There was no statistically significant difference in failure to control bleeding by day 5 or failure to prevent rebleeding after day 5, total hospital length of stay in the first admission, total ICU and hospital length of stay up to 42 days, or 5 and 42-day mortality rates between the two groups. Furthermore, 14.3% Ann Intern Med.

Resuscitation 52

Resuscitation Blood Transfusions Outcomes Hospitals 52

Downeast Emergency Medicine

APRIL 26, 2021

Four level-1 US trauma centers participated in the study where the inclusion criteria were trauma patients who were within 2 hours of their injury and were transported to the trauma center from either the field or another hospital. When looking at the subgroups with severe shock, there was an 18.5% MI or stroke).

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Taming the SRU

OCTOBER 25, 2023

Goals of treatment: Control hemorrhage, reduce risk of early-rebleeding (within 5 days), prevent bleed-related complications (infection, hepatic encephalopathy, AKI) (12) Standard of care includes: Vasoactive drugs + prophylactic antibiotics + endoscopic techniques Vasoactive drugs: IV octreotide 50ug bolus + 25 or 50 ug/h infusion Other options include (..)

Blood Transfusions 98

Blood Transfusions Stroke Hospitals Anaphylaxis 98

EMDocs

MARCH 6, 2024

shock index > 1, evidence of poor systemic perfusion). Post-hoc analysis of patients with LGIB compared a liberal transfusion threshold of 9 g/dL (8 g/dL in those with acute coronary syndrome) with restrictive strategy and found no difference in in-hospital mortality. CTA is not necessarily in all patients with LGIB.

Blood Transfusions 106

Blood Transfusions Outcomes Resuscitation Radiology 106

EMDocs

JUNE 3, 2023

Her Glasgow Coma Scale (GCS) is 14 (3E-5V-6M), and she arrives in a cervical collar placed pre-hospital. 4 Patients with pelvic fractures are considered unstable when systolic blood pressure < 90mmHg and heart rate >120bpm, or in those with dyspnea, altered mental status, or skin findings of shock. J Clin Orthop Trauma.

Fractures 65

Fractures Resuscitation Operations EMS 65

Don't Forget the Bubbles

NOVEMBER 18, 2024

Epidemiology in Australia In Australia, the reported prevalence of neonatal hypotension in preterm infants is like that in the UK, with around 20-30% of very low birth weight infants experiencing significant hypotension during their initial hospital stay. Check the haemoglobin and haematocrit levels early in these cases. Fernandez, E.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

Pediatric EM Morsels

MARCH 7, 2025

While transfusing blood can be beneficial to those who have lost it or continue to lose it quickly, blood may not always be immediately available. Or maybe the family does not desire blood transfusions. Tranexamic Acid Use in United States Children’s Hospitals. 2010Jul 03;376(9734):23-32. J Emerg Med.

Pediatrics 231

Pediatrics Blood Transfusions Anaphylaxis Military 231

EMDocs

JUNE 27, 2024

His medical history is significant for three prior admissions for vaso-occlusive crises that have responded well to appropriate therapy, including pain control with NSAIDs and opioids, blood transfusions, antibiotics, and intravenous (IV) crystalloids. Triage vital signs include BP 127/81, HR 119, T 102.9 C or 100.4 mg/kg, max 0.4

Pediatrics 98

Pediatrics Dehydration EMS Hospitals 98

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

Don't Forget the Bubbles

JULY 5, 2023

Be careful if the patient has received a recent blood transfusion since it may be misinterpreted as sickle cell trait instead of sickle cell disease. In these cases, repeat the Hb electrophoresis three months after the last blood transfusion. What medications would you give to control pain in hospital?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Don't Forget the Bubbles

FEBRUARY 24, 2025

Two-month-old Isla presents to their local hospital following a prolonged apnoea at home. The condition increases blood viscosity and pulmonary vascular resistance, leading to pulmonary hypertension, haemodynamic collapse, and, ultimately, death due to hypoxaemia and refractory shock. Nieves et al. Pediatr Infect Dis J.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

EMDocs

JANUARY 6, 2025

Based on available hospital resources, the patient is treated for septic shock secondary to pneumonia and an infected wound using broad-spectrum antibiotics and IV crystalloid fluids. A whole blood transfusion is initiated for the management of her anemia. Hypoglycemia is managed with IV dextrose.

Infectious Diseases 75

Infectious Diseases CDC PPE Rapid Diagnostic Testing 75