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SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis

The Skeptics' Guide to EM

Monocyte distribution width (MDW) as a screening tool for early detecting sepsis: a systematic review and meta-analysis. 2022 Date: February 21, 2025 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Vice Chair of Critical Care Medicine at Mayo Clinic Arizona.

Sepsis 61
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EM@3AM: Leukopenia

EMDocs

PCP Pneumonia, Sepsis) can be discharged with initiation of Antiretroviral Therapy in consultation with Infectious Disease (ID) physician with full ID evaluation outpatient. A 45-year-old outdoor enthusiast presents to the emergency department with fever, headache, myalgias, and malaise. No rash is identified.

EMS 96
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These are the ‘Roids you are looking for – Steroids in the ED

EM Ottawa

From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of conditions encountered in the Emergency Department (ED).

Shock 113
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EM@3AM: Pediatric Osteomyelitis

EMDocs

A) Factor VIII deficiency B) Hereditary spherocytosis C) Recently reduced closed long bone fracture D) Sickle cell disease Correct answer: D Osteomyelitis is a bacterial infection of the bone typically caused by hematogenous spread of a bloodborne bacteria. due to chronic granulomatous disease). Pediatr Emerg Care.

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The 79th Bubble Wrap x Bristol Royal Hospital For Children

Don't Forget the Bubbles

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. Reviewed by: John Coveney Article 2: How do we define sepsis in children?

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Diagnostics: Inflammatory Markers

Taming the SRU

While PCT may be more specific for bacterial infections, it is flawed by still being rather non-specific and is not validated as a stand-alone diagnostic criteria for infection in the setting of the emergency department. In 7 studies with 4164 patients, PCT with a cut-off > 0.1 ng/mL (strongly recommended against antibiotics), 0.1-0.25

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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Taming the SRU

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). Scandinavian journal of infectious diseases , 45 (9), 657–663. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America , 39 (9), 1267–1284.