RebelEM

MARCH 27, 2023

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. 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

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

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

EMDocs

OCTOBER 28, 2023

Spoon Feed Don’t hang your hat on lactate clearance to assess therapeutic response to resuscitation in sepsis; there are too many confounders, and initial clearance does not necessarily project clinical course. Clay Smith at @spoonfedEM , and sign up for email updates here. #1: 1: How Useful Is Lactate Clearance Anyway?

Emergency Department 66

Emergency Department Pediatrics Sepsis Resuscitation 66

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

EMDocs

AUGUST 22, 2023

Capnography has several novel uses in other disease states commonly seen in the ED such as trauma, DKA, sepsis and obstructive lung disease. Capnography in the Emergency Department: A Review of Uses, Waveforms, and Limitations. J Emerg Med. Ann Emerg Med. West J Emerg Med. BMC Emerg Med. Circulation.

Emergency Department 68

Emergency Department Blood Transfusions Resuscitation Sepsis 68

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. The Lancet Nov 2017.

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

The Skeptics' Guide to EM

JUNE 6, 2020

Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Guest Skeptic: Dr. 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).

Sepsis 52

Sepsis Shock Resuscitation Administration 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 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

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. and Emergency Medicine residents, in 12 hour shifts.

Emergency Department 52

Emergency Department Hospitals Outcomes Wellness 52

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

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. N Engl J Med.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Dr. Smith's ECG Blog

OCTOBER 26, 2010

He presented to the Emergency Department with a blood pressure of 111/66 and a pulse of 117. More often, tachycardia with ST segment abnormalities (elevation or depression) is due to an underlying illness (PE, sepsis, hemorrhage, dehydration, hypoxia, respiratory failure, etc.). Large volume fluid resuscitation was undertaken.

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

EM Curious

JULY 8, 2015

LACTATE KNOWLEDGE BOMB UNDERSTANDING LACTATE IN SEPSIS [BLOG]: Raise your hand if you think elevated lactic acid in sepsis is from anaerobic metabolism? BENIGN EARLY REPOLARIZATION [BLOG]: Have a quick skill brush-up on this common ECG finding that could be looking quite concerning if you are not familiar with it.

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

EMDocs

OCTOBER 8, 2024

The full differential diagnosis of sinus tachycardia in isolation is extensive ranging from benign etiologies such as anxiety to severely life threatening etiologies such as sepsis. Additional resuscitation Have we addressed all potential sources of shock for the patient in front of us? Ann Emerg Med. Acad Emerg Med.

Shock 95

Shock Emergency Department Pediatrics EKG/ECG 95

Taming the SRU

JANUARY 12, 2024

r4 case follow up - r1 clinical knowledge: interstitial lung disease - halo - pediatric simulation - pediatric small groups r4 case follow up WITH dr. yates Psychiatric emergency department visits are on the rise in the United States, with roughly 15-19% of all ED visits associated with mental health diagnoses Roughly twenty percent of patients presenting (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

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. Jeff: Let’s move on to evaluation in the emergency department. Jeff: You’re right.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EB Medicine

JULY 8, 2019

This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Some may present with isolated tachycardia while others may present with profound sepsis – tachycardia, hypotension, and fever.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

PEMBlog

AUGUST 20, 2024

This episode of PEM Currents discusses ECPR (Extracorporeal Cardiopulmonary Resuscitation), an advanced procedure used in cases of cardiac arrest when traditional CPR fails. Extracorporeal Cardiopulmonary Resuscitation. Pediatric Emergency Care , 40(8), 618-622. Resuscitation. These could include severe sepsis.

CPR 52

CPR Resuscitation Pediatrics Hospitals 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

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. Complications of acute gallbladder perforation include localized peritonitis, hepatic, subhepatic, or pelvic abscess formation, pneumonia, pancreatitis, acute renal failure, and sepsis (7).

Ultrasounds 77

Ultrasounds Sepsis Radiology Radiology 77

Northwestern EM Blog

JANUARY 24, 2022

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. There is a subset of patients who, despite aggressive conventional resuscitation, have an inadequate hemodynamic response and develop refractory shock. Curr Opin Crit Care. 5) Kerns W.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

The Skeptics' Guide to EM

FEBRUARY 24, 2018

Guest Skeptic: Dr. Rory Spiegel (@EMNerd_) is a clinical instructor at University of Maryland, a recent graduate of Stony Brook’s Resuscitation Fellowship, and a current Critical Care fellow at University of Maryland. Over the course of his emergency department stay he has escalating vasopressor requirements. NEJM January 2018.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

Don't Forget the Bubbles

MAY 8, 2024

A silent scream in the pediatric emergency department: child abuse and neglect. Emergency department discharge practices for children with acute wheeze and asthma: a survey of discharge practice and review of safety netting instructions in the UK and Ireland. Akkaya B et al. Eur J Pediatr. 2024 Apr 13. Yager H et al.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

Don't Forget the Bubbles

NOVEMBER 18, 2024

Sepsis: This can induce widespread vasodilation and capillary leak, exacerbating hypotension. The other important moment to always think of the heart (sorry, cardiologists, I don’t think about the heart 24/7) is when a collapsed neonate presents to your emergency department, especially if blood pressure is present.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

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.

Poisoning 52

Poisoning Administration Hospitals Outcomes 52

Don't Forget the Bubbles

OCTOBER 2, 2024

Children often spend many hours in the emergency department (ED) before being sent home or admitted. In this issue of Pediatrics , Leyenaar and colleagues reported on a trial to compare the effectiveness of direct admission to bypass their emergency departments. Räty S, et al. Eur J Pediatr. 2024 Sep 28. Kemps N, et al.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Urgent Care 52

The Skeptics' Guide to EM

JANUARY 25, 2020

His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Case: A 60-year-old male is […] The post SGEM#281: EM Docs Got an AmbuBag – The PreVent Trial first appeared on The Skeptics Guide to Emergency Medicine. He has worsening work of breathing and a decreasing level of consciousness.

EMS 40

EMS Airway Management Administration Resuscitation 40

Pediatric Emergency Playbook

APRIL 1, 2016

used BNP in the emergency department to differentiate heart failure from respiratory causes in infants and children with heart failure and those with no past medical history. Lactate A sick child with sepsis syndrome? The acute recognition and treatment of sepsis is first and foremost, clinical. Later, Maher et al.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 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%

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

Pediatric Emergency Playbook

AUGUST 1, 2017

One of our largest responsibilities in the Emergency Department is sorting out benign from surgical or medical causes of abdominal pain. Abdominal Surgical Emergencies in Children: A Relative Timeline General Advice Neonate (birth to one month) Necrotizing Enterocolitis Pneumatosis Intestinalis.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

EMDocs

JUNE 27, 2024

Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. -smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0

Pediatrics 76

Pediatrics EMS Dehydration Hospitals 76

Don't Forget the Bubbles

FEBRUARY 5, 2024

Role of diagnostic tests for sepsis in children: a review. Sustained inflation and chest compression versus 3:1 chest compression to ventilation ratio during cardiopulmonary resuscitation of asphyxiated newborns (SURV1VE): A cluster randomised controlled trial. Anagnostou A, et al. Arch Dis Child. 2024 Jan 12:archdischild-2023-326225.

Pediatrics 52

Pediatrics Research Resuscitation Psychiatric 52

Pediatric Emergency Playbook

JUNE 1, 2016

Distributive Shock The most common cause of distributive shock is sepsis, followed by anaphylactic, toxicologic, adrenal, and neurogenic causes. Children with sepsis come in two varieties: warm shock and cold shock. Pulmonary embolism in the pediatric emergency department. Look at the volume status – the FILL. Pediatrics.

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

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

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52