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

EB Medicine

JANUARY 10, 2020

Show Notes Please click here and take our listener survey Emergency Department management of Non-St Segment Elevation Myocardial Infarction, by Drs Julianna Jung and Sharon Bord. In-hospital mortality rates are about the same for STEMI and NSTEMI, about 10%. This can be the result of hypotension, tachycardia, sepsis, PE, etc.

Emergency Department 40

Emergency Department Shock EKG/ECG Sepsis 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 Wellness Emergency Department 60

Taming the SRU

SEPTEMBER 16, 2024

In the era of modern medicine, blood transfusions are commonplace, especially in the emergency department. While they are a lifesaving staple of medicine, they also come with risks that emergency providers must be aware of. Journal of Clinical Medicine , vol. 10, 19 May 2022, p. 2859, [link] Afroz, Tamanna, et al.

Blood Transfusions 60

Blood Transfusions Anaphylaxis Emergency Department Sepsis 60

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 Outcomes CPR Sepsis 98

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This blog post aims to help familiarise you with some of the most common reasons for prescribing antibiotics in the paediatric emergency department. Antibiotic Use for Common Infections in Pediatric Emergency Departments: A Narrative Review. This is true in life-threatening conditions such as sepsis. Hibberd, O.;

Emergency Department 142

Emergency Department Infectious Diseases Pediatrics Sepsis 142

PulmCCM

OCTOBER 23, 2023

Cefepime crosses the blood-brain barrier, and dozens of case reports have associated the drug with seizures, encephalopathy, delirium, and coma, with a possibly increased incidence of neurologic adverse effects among patients with renal failure or sepsis. Paxlovid also did not reduce symptoms of Covid-19 in that trial.

Hospitals 98

Hospitals Emergency Department COPD CDC 98

Taming the SRU

MAY 5, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. N Engl J Med. 2023;388(6):499-510.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

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

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

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 93

Sepsis Administration Documentation/Coding Fractures 93

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

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 Outcomes 52

ACEP Now

MAY 4, 2023

Case A 37-year-old white male with no past medical history presented to the emergency department (ED) for left testicular pain, redness, and swelling. Early treatment with broad-spectrum antibiotics is essential to prevent sepsis and preserve testicular function. Dr. Rader works at Ascension Macomb-Oakland Hospital.

Urgent Care 52

Urgent Care Ultrasounds Sepsis Emergency Department 52

The Skeptics' Guide to EM

JUNE 15, 2018

Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.

Emergency Department 52

Emergency Department Fluid Resuscitation Hospitals Sepsis 52

Don't Forget the Bubbles

MAY 8, 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). A silent scream in the pediatric emergency department: child abuse and neglect. Can’t get enough of Bubble Wrap? Akkaya B et al. 2024 Apr 13.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

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

PEMBlog

MARCH 27, 2024

This episode will help you better prepare for and manage children with inborn errors of metabolism in the Emergency Department. Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast. But now I’m going to pass the mic.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

EMDocs

NOVEMBER 27, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

EMS 71

EMS Sepsis EKG/ECG Burns 71

Don't Forget the Bubbles

MARCH 4, 2024

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The children’s Emergency department sees approximately 50,000 presentations per year. Paediatr Int Child Health. 2024 Jan 11:1-7. Epub ahead of print.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

RebelEM

MARCH 9, 2023

However, evaluating and managing patients with acute alcohol intoxication in the emergency department can be challenging. Pain / Additional Complaints : Alcohol can weaken the immune system with only moderate use, predisposing individuals to pneumonia, soft tissue infections, and sepsis. Annals of Emergency Medicine.

Psychiatric 52

Psychiatric Emergency Department Documentation/Coding Fractures 52

PEMBlog

OCTOBER 18, 2023

Initially in the emergency department he was generally well-appearing with normal vital signs. rectally, prompting a sepsis workup given his age. This patient was hospitalized for 4 days where he remained well-appearing. She did have a remote history of oral cold sores but no recent lesions. x 10E+09/L with ANC 4.46

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

Taming the SRU

MAY 1, 2023

A retrospective evaluation of phenobarbital versus benzodiazepines for the treatment of alcohol withdrawal in a regional Canadian emergency department Link: [link] Bottom Line: This study in a small regional ED showed a QI project rolling out a Phenobarbital or Diazepam for Alchohol withdrawal syndrome. and NPV(50%).

Poisoning 52

Poisoning Hyperthermia / Hypothermia Emergency Department Seizures 52

ACEP Now

OCTOBER 10, 2023

A 76-year-old female presents to the emergency department obtunded with left hemiplegia. Hospitals should incorporate this approach into clinical practice as part of active management for this serious condition.” External Validity: It is unclear if this data applies to patient you see in your emergency department.

Outcomes 52

Outcomes Stroke Hospitals Emergency Department 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 76

Ultrasounds Sepsis Radiology Radiology 76

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

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 Outcomes Research Hospitals 78

EMDocs

JUNE 27, 2024

768: Epidemiology of Hospital Based ED Visits due to Sickle Cell Crisis and Acute Chest Syndrome in Kids. This series provides evidence-based updates to previous posts so you can stay current with what you need to know. C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1

Pediatrics 75

Pediatrics EMS Dehydration Hospitals 75

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.

Administration 52

Administration Poisoning Hospitals Outcomes 52

PEMBlog

JANUARY 17, 2024

Full blown sepsis and toxic shock syndrome. Well, you definitely shouldn’t be sending a blood culture because if you’re worried about bacteremia and sepsis, that kid needs to stay in the hospital. So when do you want to think about admission to the hospital or short stay unit versus discharge?

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

ACEP Now

MARCH 6, 2024

7 The operators involved in the trial were mostly emergency medicine residents or critical care fellows, but this fact does not diminish the generalizability of these observations. Many clinicians staffing emergency departments intubate infrequently, as well, and these results are likely applicable to a wide scope of practice.

Research 52

Research Airway Management Stroke Outcomes 52

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 71

EMS Dehydration Ultrasounds Emergency Department 71

PulmCCM

JUNE 19, 2023

No drug or combination improved the primary outcome (a composite outcome of hypoxemia, visit to the emergency department, hospitalization, or death). Sepsis was a main trigger, and hypothermia and shock were as common (>50%) as coma. That was in NEJM Aug 18 2022. and FT4 (0-7.8

Infectious Diseases 52

Infectious Diseases Outcomes Hyperthermia / Hypothermia Sepsis 52

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9% Do not transport to an alternative location.

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

Don't Forget the Bubbles

FEBRUARY 5, 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). Role of diagnostic tests for sepsis in children: a review. Can’t get enough of Bubble Wrap? Anagnostou A, et al. Arch Dis Child. Rodgers O, et al.

Pediatrics 52

Pediatrics Research Resuscitation Outcomes 52

The Skeptics' Guide to EM

JANUARY 25, 2020

Case: A 60-year-old male is in your emergency department with sepsis from pneumonia. Background: Emergency medicine is often referred to as the ABC (Airway, Breathing and Circulation) specialty. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound.

EMS 40

EMS Airway Management Administration Resuscitation 40

Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). 2018) Epidemiology of lumbar punctures in hospitalized patients in the United States. WHO - Who Needs an LP in the ED? Patients with concern for infection (i.e., PLOS ONE 13(12): e0208622.

Infectious Diseases 95

Infectious Diseases Seizures Ultrasounds Sepsis 95