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2023 Critical Care Year in Review (Part 1)

PulmCCM

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.

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Travel-Related Illnesses in Children

Pediatric EM Morsels

However, the destination of travel is also important as helminths have distinct geographical distribution.

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Post #3 Back-to-Sleep series

Sensible Medicine

In his work, Dr. Goldwater describes a kind of toxic-shock (cytokine) reaction in the body that results from the combination of a cold virus plus being infected with a common bacterium—each pathogen relatively harmless on its own but deadly together. This sort of sepsis would produce many of the common autopsy findings.

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The Latest in Critical Care, 3/4/24 (Issue #32)

PulmCCM

New criteria for diagnosis of pediatric sepsis The diagnosis of pediatric sepsis will abandon the so-called SIRS criteria in favor of a simple organ-failure score. A score of 2 or higher on the Phoenix-4 in a child with suspected or confirmed infection would diagnose sepsis.

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The Latest in Critical Care, 10/30/23 (Issue #18)

PulmCCM

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).

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Is Pip-Tazo Harming Sepsis Patients?

RebelEM

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.

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Mpox in adult patients: updates on diagnosis and clinical management in the ED

EMDocs

The outbreak spread to four additional African countries, leading the Africa CDC to declare it a Public Health Emergency of Continental Security. 43 As shown in Table 1, the CDC recommends acetaminophen or NSAIDs for general pain relief, with gabapentin or opioids reserved for more severe cases. In: CDC Yellowbook. 43 Table 3.

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