Pediatric EM Morsels

FEBRUARY 2, 2024

Hospitalization for travel-related illness are around 10% for both VFR and tourists (Leuthard 2015) Multiple studies have reported the most common travel infections in various countries. Internationally Acquired Severe Systemic Infections in Febrile Pediatric Travelers Presenting to the Emergency Department. Pediatr Emerg Care.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

Taming the SRU

JUNE 11, 2023

End-tidal carbon dioxide measured at emergency department triage outperforms standard triage vital signs in predicting in-hospital mortality and intensive care unit admission. Acad Emerg Med 2023; 10.1111/acem.14703 Acad Emerg Med 2023; 10.1111/acem.14703 The primary outcome was in-hospital mortality.

Hospitals 86

Hospitals Emergency Department EMS Outcomes 86

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 82

Dehydration Fluid Resuscitation Administration Resuscitation 82

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 Hospitals 52

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

ACEP Now

JANUARY 5, 2025

The PREOXI trial compared oxygen mask pre-oxygenation versus noninvasive positive-pressure ventilation (NIPPV) in patients requiring intubation in emergency departments (EDs) and intensive care units. Sepsis Robots or Sepsis Humans The proliferation of sepsis alerts in the ED has reached levels best described as obscene.

Sepsis 40

Sepsis Research Airway Management Outcomes 40

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

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 88

Seizures Emergency Department Hyperthermia / Hypothermia EMS 88

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 88

Sepsis Burns Shock Operations 88

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

EM Updates

JUNE 15, 2021

Maimonides Medical Center (MMC) is Brooklyn’s largest hospital, an academic quaternary care center with, in normal times, 711 total beds, 66 intensive care beds, and an Emergency Department that treats approximately 120,000 patients per year. On March 9, the first patient with a novel coronavirus infection was admitted to MMC.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

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

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 106

Outcomes Research Sepsis Emergency Department 106

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

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

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 124

EKG/ECG Shock Emergency Department Ambulance Services 124

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 94

Sepsis Fractures Documentation/Coding Administration 94

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 95

Outcomes Administration Emergency Department Resuscitation 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

Don't Forget the Bubbles

JUNE 30, 2023

Importantly, there were no differences between the groups regarding complications, including acute respiratory distress syndrome, multiple organ failure, venous thromboembolism, sepsis, and transfusion-related complications. b) Emergency thoracotomy Let’s be clear: YOU will not be doing any of this.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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

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

Don't Forget the Bubbles

JULY 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. Evaluating the Impact of the 2017 Dutch Neonatal Early-Onset Sepsis Guideline. Can’t get enough of Bubble Wrap? Paediatr Child Health. 2023 Jun 15.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

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 72

EMS Sepsis Shock Fluid Resuscitation 72

Don't Forget the Bubbles

JULY 5, 2023

GPs and local hospitals should provide easy access to medication and vaccinations to ensure good compliance. Vaccination: PCV13 (pneumococcal vaccination), meningococcal vaccines, and Hib conjugated vaccines are important to prevent life-threatening sepsis. What medications would you give to control pain in hospital?

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

Taming the SRU

AUGUST 30, 2023

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear. ng/mL, 0.25-0.5

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

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

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

NOVEMBER 1, 2018

But this month’s episode is special in its own way - we’ll be tackling Electrical Injuries in the emergency department - from low and high voltage injuries to the more extreme and rare lightning related injuries. In at least one study, the incidence of DVT in hospitalized burn patients was as high as 23%. Jeff: You’re right.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

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

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.

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Sepsis Academics Operations Emergency Department 60