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Sepsis Screening Decreases Mortality. Well, not really.

Sensible Medicine

This comment might be one of the reasons I’ve been skeptical of sepsis screening. Sepsis screening, for me, comes in many different flavors -- from EMR alerts based on lab and vital sign data to anyone being able to draw a lactate or call an RRT. .” So said my program director during my internship. 0.93; P < 001.

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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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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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Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

RebelEM

For those with sepsis, the administration of intravenous fluids (IVF) at the volumes recommended in the Surviving Sepsis Campaign (SSC) requires careful consideration of an individual’s chronic medical conditions and subsequent sensitivity to IVF. Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Am J Emerg Med.

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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 92
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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.

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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.