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Clinical Conundrum: Should We Always Treat Fever in Patients with Sepsis?

RebelEM

Bottom Line Up Top: There doesnt appear to be a morbidity or mortality benefit to treating fever in sepsis and fever may have a protective effect. A large observational study of > 2000 patients found an association with fever at presentation and ICU survival for patients with severe sepsis or septic shock ( Sunden-Culberg 2017 ).

Sepsis 72
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Emergency Department Evaluation of Cholestatic Labs

EMDocs

Authors: Amelia Campbell, MD (EM Resident Physician, Carl R. Darnall Army Medical Center) and Alec Pawlukiewicz, MD (EM Attending Physician, Carl R. Case: A 45-year-old woman presents to the emergency department (ED) with itching to bilateral palms. How does cholestasis present? Mayo Clin Proc. 2020;95(10):2263-2279.

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EM@3AM: Stercoral Colitis

EMDocs

Well keep it short, while you keep that EM brain sharp. A 73-year-old female is brought in by EMS for abdominal pain, vomiting, and weakness for two days. 2-4, 6 If there is a concern for perforation or sepsis, surgical consultation, blood cultures, empiric antibiotics, and fluids are recommended.

EMS 72
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EM@3AM: Brainstem Strokes

EMDocs

We’ll keep it short, while you keep that EM brain sharp. A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. Ann Emerg Med. Erratum in: Ann Emerg Med.

Stroke 89
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Episode 7: Sepsis

PHEM Cast

[link] We hope you enjoyed our sepsis podcast. It is obviously a huge topic and there is lots of information to cover; a couple of other recently released podcasts are available which are produced with the Emergency Medicine community in mind, but will no doubt expand your knowledge. St Emlyns Induction podcast on Sepsis.

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Cuffed Endotracheal Tubes for Children: ReBaked Morsel

Pediatric EM Morsels

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. Paediatr Anaesth. doi: 10.1111/pan.14185.

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emDOCs Revamp: Alcohol Withdrawal

EMDocs

A 36-year-old male presents to the emergency department after being found down at home by his spouse. Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. Acad Emerg Med. This series provides evidence-based updates to previous posts so you can stay current with what you need to know.