Northwestern EM Blog

JULY 15, 2024

Edmonson and Adler for this infographic that concisely emphasizes key concepts for the recognition and initial management of acute respiratory distress syndrome (ARDS) in the Emergency Department. Careful selection of refractory cases for VV-ECMO is advised (P:F < 80 or refractory respiratory acidosis with pH < 7.25).

Resuscitation 98

Resuscitation Burns Emergency Department Sepsis 98

Taming the SRU

DECEMBER 17, 2024

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. There is substantial evidence that IV fluids can be beneficial in patients with sepsis complicated by hypotension and labor. Emerg Med Australas 2013;25(6):52734. AtherlyJohn et al.

Dehydration 83

Dehydration Fluid Resuscitation Administration Resuscitation 83

EMDocs

DECEMBER 18, 2024

A 36-year-old male presents to the emergency department after being found down at home by his spouse. This series provides evidence-based updates to previous posts so you can stay current with what you need to know. fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

Seizures 99

Seizures Hyperthermia / Hypothermia Emergency Department EMS 99

ACEP Now

MAY 9, 2024

Complications of Gluteal AFT The pale, prone patient with multiple surgical drains and a constrictive faja has become a common site in the Jackson Memorial Hospital Emergency Department. Nearly half of all post-AFT patients presenting to our emergency departments required admission and six percent required ICU admission.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

PulmCCM

JANUARY 23, 2025

Various new “sepsis tests” have come to market or will soon, claiming to solve the problem of diagnostic imprecision in the early management of suspected sepsis. The lack of a reliable diagnostic test or universally accepted criteria to diagnose sepsis leads to significant challenges in clinical practice and research.

Sepsis 45

Sepsis Wellness Emergency Department Research 45

Don't Forget the Bubbles

AUGUST 7, 2023

Heart rate (HR) and respiratory rate (RR) are THE major vital signs used in Advanced Paediatric Life Support ( APLS) guidance , sepsis guidelines , and Paediatric Early Warning Scores (e.g., Identify the percentage of children whose heart or respiratory rate would exceed the “severe” cut-off from the UK Sepsis Trust and NICE guidelines.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

The Skeptics' Guide to EM

FEBRUARY 17, 2018

Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. Case: EMS is dispatched to a retirement […] The post SGEM#207: Ahh (Don’t) Push It – Pre-Hospital IV Antibiotics for Sepsis. first appeared on The Skeptics Guide to Emergency Medicine. The Lancet Nov 2017.

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

RebelEM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. Paper: Owyang CG, et al. J Crit Care. J Crit Care. N Engl J Med. Crit Care Explor.

Emergency Department 52

Emergency Department Operations Documentation/Coding Academics 52

The Skeptics' Guide to EM

SEPTEMBER 25, 2021

Most emergency department patients meeting sepsis criteria are not diagnosed with sepsis at discharge. Guest Skeptic: Dr. Jess Monas is a Consultant in the Department of Emergency Medicine at the Mayo Clinic Hospital, Phoenix, Arizona. Date: September 20th, 2021 Reference: Litell et al.

Sepsis 40

Sepsis Emergency Department COPD Hospitals 40

EM Literature of Note

OCTOBER 9, 2024

This exploration of LLMs in the emergency department is a bit unique in its conceptualization. and GPT-4T – is asked: Should this patient be admitted to the hospital? Effectively, what ought to have been asked of the LLMs – and the clinician reviewers – was “ did this patient get admitted to the hospital?”

Radiology 86

Radiology Radiology Emergency Department Documentation/Coding 86

Taming the SRU

AUGUST 11, 2024

ABEM updates - R4 Capstone - Sepsis Operations update - R3 taming the sru - traveler’s diarrhea abem updates WITH dr. melissa platt, abem board of directors Beginning 2026, ABEM will be requiring a new certifying exam to replace the previous oral boards.

Sepsis 89

Sepsis Burns Shock Operations 89

RebelEM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department. Am J Emerg Med. Am J Emerg Med. 2022 Sep 7.

Emergency Department 52

Emergency Department Administration EMS Dehydration 52

Sensible Medicine

JULY 29, 2024

Yet the failure of the hospital readmission penalty policy and sepsis protocols expose the risks of implementing a policy because it sounds good. Their primary endpoint was emergency department visits. Drugs, devices and treatment strategies often face the challenge of randomized trials. Their results were sobering.

Outcomes 110

Outcomes Research Sepsis Emergency Department 110

Don't Forget the Bubbles

MAY 6, 2024

For a deep dive into intubation, see Intubation of the critically unwell Child in the emergency department – Don’t Forget the Bubbles (dontforgetthebubbles.com) For all things neonatal (lines and tubes), see Neonatal lines and tubes – Don’t Forget the Bubbles (dontforgetthebubbles.com) Why does it matter?

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

Dr. Smith's ECG Blog

OCTOBER 20, 2024

sepsis, anemia, hypoxemia, severe hypotension etc., The patient was rushed to the nearest emergency department (non-PCI facility) for stabilization. He was later transferred back to his local hospital neurologically intact and without serious sequela. The patient was given aspirin and heparin.

EKG/ECG 131

EKG/ECG Shock Emergency Department Ambulance Services 131

Critical Care Now

JULY 14, 2024

This week’s article, by Heuts et al, titled “Extracorporeal cardiopulmonary resuscitation versus standard treatment for refractory out-of-hospital cardiac arrest: a Bayesian meta-analysis” is a fresh take on the issue. Now, before we dive into the weeds, we need to establish what exactly a Bayesian meta-analysis is.

Resuscitation 98

Resuscitation CPR Outcomes Sepsis 98

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane). Lane & Mcdonough Definition of an immediate whole body CT (iWBCT) scan Shortly after patient arrival.

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia. Case: You are working night shift in the emergency department.

Sepsis 52

Sepsis Emergency Department Seizures Pediatrics 52

RebelEM

JULY 17, 2023

Background: Standard rapid sequence intubation (RSI) in the emergency department involves administration of an induction agent and a neuroblocking agent in quick succession. appeared first on REBEL EM - Emergency Medicine Blog. Range 5 to 9) Etomidate: 7.0 Range 5 to 9) Diff -0.2; 95% CI -1.4

Outcomes 90

Outcomes Administration Emergency Department Resuscitation 90

EMDocs

JANUARY 11, 2025

Clinical exam: 2, 3, 9 Abdominal distension and tenderness Nausea and vomiting Stool present in the rectal vault Peritonitis may be accompanied by hemodynamic instability in the case of sepsis. 2-4, 6 If there is a concern for perforation or sepsis, surgical consultation, blood cultures, empiric antibiotics, and fluids are recommended.

EMS 88

EMS Sepsis Shock Fluid Resuscitation 88

The Skeptics' Guide to EM

OCTOBER 23, 2021

Pathway with single-dose long-acting intravenous antibiotic reduces emergency department hospitalizations of patients with skin infections. AEM October 2021 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate.

Emergency Department 52

Emergency Department Sepsis Hospitals Research 52

The Skeptics' Guide to EM

JUNE 6, 2020

Max Hockstein trained as an Emergency Medicine physician at University of Texas Southwestern and is finishing his Intensive Care fellowship at Emory. Case: It’s another day in your emergency department (ED). Background: I think we have covered sepsis more often than any other topic on the SGEM.

Sepsis 52

Sepsis Shock Resuscitation Administration 52

ALiEM

FEBRUARY 9, 2024

Intermediate-risk patients may be further stratified based on recent stress testing or coronary angiogram findings plus a modified HEART or Emergency Department Assessment of Chest Pain (EDACS) score. These in the high-risk category are usually admitted to the hospital to assess for AMI as well as other causes of troponin elevation.

EKG/ECG 110

EKG/ECG Emergency Department Burns Wellness 110

EB Medicine

MARCH 4, 2020

Stool Cultures: 2017 IDSA guidelines recommends them in patients with fever, bloody or mucoid stools, severe abdominal cramping or tenderness, or signs of sepsis, noting these patients are at higher risk of bacterial infection. Consider them for immunocompromised patients and those with recent abx use or hospitalization.

Emergency Department 40

Emergency Department Dehydration Poisoning Allergic Reactions 40

Don't Forget the Bubbles

MAY 17, 2023

The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. Original clinical studies The impact of the early onset neonatal sepsis calculator on antibiotic initiation: a single center study in Israel. Levi M, et al.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

EB Medicine

SEPTEMBER 1, 2018

Jeff: Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta and we’ll be taking you through the September 2018 issue of Emergency Medicine Practice - Emergency Department Management of North American Snake envenomations.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

ALiEM

SEPTEMBER 9, 2024

A 61-year-old female with a past medical history of hypertension, hyperlipidemia, type 2 diabetes, and normal pressure hydrocephalus s/p VP shunt (last revision nine months ago) presented to the Emergency Department (ED) for evaluation after noticing a “string” coming out of her anus today.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

The Skeptics' Guide to EM

JANUARY 15, 2022

Intensive Care Med 2021 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a professor of Emergency Medical Services at Tacoma Community College’s paramedic program. Background: We have covered the issue of intubation multiple times on the SGEM.

Sepsis 42

Sepsis Shock Emergency Department Outcomes 42

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Case: You’re working a shift in a rural emergency department when a 68-year-old man presents with a two-day course of worsening cough, shortness of breath, and fever. Their workup reveals a multifocal pneumonia with signs of sepsis. The Lancet 2018.

Poisoning 52

Poisoning Administration Hospitals Sepsis 52

Don't Forget the Bubbles

AUGUST 4, 2024

The Bubble Wrap Plus is a monthly Paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). Reviews and opinion articles Implementing Acute Hospital Care at Home in Pediatrics. Neonatal bacterial sepsis. Brewster RCL, et al.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Pediatrics Burns Sepsis 52

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. He was transitioned to cefdinir and fluconazole for a full 7-day course of antibiotics and discharged from the hospital on day three, with instructions to follow up with general surgery for an outpatient cholecystectomy.

Ultrasounds 78

Ultrasounds Sepsis Radiology Radiology 78

The Skeptics' Guide to EM

FEBRUARY 10, 2018

Lancet January 2018 Guest Skeptic: Dr. Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital.

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

EMDocs

JULY 29, 2023

A 75-year-old male with past history of HTN, CVA, DM II presents to the emergency department with right facial swelling since last night. We’ll keep it short, while you keep that EM brain sharp. He is also complaining of pain and subjective fevers. Initial vital signs include BP of 150/85, HR 103, T 100.8, RR 18, SpO2 97% on RA.

EMS 83

EMS Dehydration Ultrasounds Emergency Department 83

The Skeptics' Guide to EM

JULY 16, 2022

Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University. Date: July 16th, 2022 Reference: Lamontagne F et al.

Sepsis 40

Sepsis Shock Outcomes EMS 40

ACEP Now

JULY 7, 2024

1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED). Patients with status epilepticus require hospital admission, often to an intensive care setting. Ann Emerg Med. Utility of electroencephalogram in the pediatric emergency department.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

Don't Forget the Bubbles

JANUARY 10, 2024

Let’s take the humble blood transfusion – used in emergency departments across the globe and playing a key role in critical care. Severe anaemia is a common and life-threatening cause of hospital admission in children in sub-Saharan Africa. 8% die in hospital, with a further 12% dying in the six months following discharge.

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

Don't Forget the Bubbles

OCTOBER 2, 2024

The Bubble Wrap Plus is a monthly Paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). Children often spend many hours in the emergency department (ED) before being sent home or admitted. Can’t get enough of Bubble Wrap?

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Urgent Care 52