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Episode 7: Sepsis

PHEM Cast

And from our buddies at HEFT EM CAST: [link] A bit more detail covering some of the research in an easy to understand way. There are toolkits available to download, including one specifically written for the prehospital environment with the College of Paramedics, which summarises the recognition and management of sepsis. J Emerg Med.

Sepsis 52
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Cardiac Rhythms/ECG Module

Don't Forget the Bubbles

For anyone approaching a structured ABC would be a priority to establish whether shock was present or not. Typical features include: HR >220bpm Narrow complex regular tachycardia P waves difficult to identify In this case there is no shock present so we can proceed to the right branch of the ALSG guideline.

EKG/ECG 98
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What Minimal Volume of Intravenous Fluid Challenges the Heart?

PulmCCM

As well, the volume of administration might be much lower than 500 mL, with previous research indicating that 4 mL/kg of crystalloid was an optimal volume needed to increase mean systemic filling pressure. Download his free textbook here. ED50] and in 90% [i.e., ED90] of the patients who were ‘responders.’

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Early Modern Resuscitators

Advanced Emergency Nursing from AENJ

Joseph Kreiselman’s portable concertina-like bellows was invented and deployed in the US military from 1943 followed by the UK’s Porton Resuscitator, postwar, from its secret chemical research facility and used industrially into the early 1960s. Evaluation: Manually Operated Resuscitators (1971) Emergency Care Research Institute.

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Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

When looking at the subgroups with severe shock, there was an 18.5% When stratifying TXA administration time after injury and qualifying shock incidence, there appeared to be a lower 30 d mortality if TXA was given within 1 hour of the incident. Global neurotrauma research challenges and opportunities. MI or stroke).

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How to prevent central line infections

PulmCCM

Download the central line checklist from John Hopkins here. For example, a patient who presented with shock and mitral regurgitation, received a central line for vasopressors on day 0, and was found to have bacteremia from blood cultures drawn on day 3 due to endocarditis would have a CLABSI, but not a CRBSI.

CDC 52
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REBEL Core Cast 122.0 – Neutropenic Fever

RebelEM

REBEL Core Cast 122.0 – Neutropenic Fever Click here for Direct Download of the Podcast. BMC Health Services Research. Identify low risk patients and send them home with PO antibiotics and close oncology follow-up in conjunction with your oncologist. Give appropriate fluids, vasopressors, and antibiotics. 2014;14:162.