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CDC gives a nudge to hospitals on sepsis care

PulmCCM

The Centers for Disease Control and Prevention formally called on hospitals to develop robust sepsis care programs to systematically identify and treat sepsis, track outcomes, and improve care delivery. ” What is that, a sepsis Stasi? Unlike strokes and STEMIs, sepsis has no gold standard for diagnosis.

CDC 98
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Sepsis alerts work! Just not in the patients who fire the alerts

PulmCCM

In the past decade, so-called “sepsis alerts” came out of nowhere to become a ubiquitous and resource-intensive component of inpatient medical care. “Sepsis alerts” are automated notifications that flag patients who meet certain criteria compatible with severe infection discernible from the electronic medical record.

Sepsis 45
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The Latest in Critical Care, 2/5/24 (Issue #28)

PulmCCM

You can read the document here. Read the original document here. In 18 severe sepsis patients in 3 years at one center who underwent PET scanning (apparently done ad hoc), 14 of the 18 had positive tests, and 11 were true positives, leading to surgery in 2 and pacemaker removal in 2 (and longer / new antibiotics in 2).

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Infective Flexor Tensosynovitis (Flexor Sheath Infection)

Mind The Bleep

Management Immediate management: Consider ABCDE approach and Sepsis 6 pathway including early empirical IV antibiotics. Operative management: Surgical washout of the flexor sheath within 24 hours of the decision to operate. Consider tetanus booster if applicable. Remove all rings! Urgent referral to the hand surgery department.

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Grand Rounds Recap 7.24.24

Taming the SRU

morbidity and mortality - faculty case follow-up - R4 Capstone - high-risk, low prevalence diseases in pediatrics morbidity and mortality WITH dr. moulds Syncope Complete heart block is a rare but important cause of syncope P waves outnumbering QRS complexes should clue to you to high grade heart block Triage EKGs are often obtained to screen for cardiac (..)

EKG/ECG 52
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The PROTECTION Trial – A Randomized Trial of Intravenous Amino Acids for Kidney Protection

RebelEM

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

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Impact of Emergency Department Crowding on Lung Protective Ventilation

RebelEM

4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. There may have very well been a policy where only RTs can make changes to a ventilator after an order was placed to ensure accurate documentation. Prior studies have used annual census or shift level crowding.