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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.

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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.

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SGEM#448: More than A Feeling – Gestalt vs CDT for Predicting Sepsis

The Skeptics' Guide to EM

Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Background: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Thus, early identification of sepsis might not be as important as sometimes stated in guidelines.

Sepsis 99
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ECG Blog #366 — Diltiazem didn't work.

Ken Grauer, MD

Figure-2: I've color-coded P waves from Figure-1 according to P wave morphology ( See text ). NOTE: For clarity — I've color-coded P waves in the long lead II rhythm strip according to morphology. MAT almost always occurs in one of 2 common predisposing settings.

EKG/ECG 195
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ED Nurse-Led Code Sepsis to Reduce Time to Antibiotics

AENJ: Current Issue

Background: Delays in sepsis recognition contribute to delays in antibiotic administration, which lead to increased morbidity and mortality in patients with sepsis. Our objective was to create an Emergency Department (ED) Code Sepsis Nurse-led team to reduce the time to antibiotics and mortality in patients with sepsis.

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Putting Clinical Gestalt to Work in the Emergency Department

ACEP Now

Our nurse did not study Paul Ekman’s Facial Action Coding System for Action Units to code “fear” in the patient’s face. This means deviating from protocols (when warranted) for sepsis because your initial impression is the patient would be harmed with that much fluid. We should respect our own and others’ gestalt assessments.

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Torsade in a patient with left bundle branch block: is there a long QT? (And: Left Bundle Pacing).

Dr. Smith's ECG Blog

She was managed for sepsis with antibiotics including azithromycin, had hypotension with arterial and central lines placed and pressors. I do not see OMI here and all trops were only minimally elevated, consistent with either chronic injury from cardiomyopathy or with acute injury from sepsis. She was intubated.

EKG/ECG 115