AENJ: Current Issue

MAY 8, 2024

This column on translating research into practice is crafted to offer advanced practice registered nurses an analysis of current research topics that hold practical relevance for emergency care settings.

Emergency Department 40

Emergency Department Outcomes Sepsis Research 40

Broome Docs

SEPTEMBER 3, 2024

In a surprise to no one who reads First10EM, clinical judgment is better than all decision tools for sepsis Knack SKS, Scott N, Driver BE, Prekker ME, Black LP, Hopson C, Maruggi E, Kaus O, Tordsen W, Puskarich MA. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients.

Sepsis 109

Sepsis Emergency Department Outcomes Hospitals 109

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. N Engl J Med. 2000 May 4; PMID: 10793162 Harvey CE, et al.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 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. Background: We have covered sepsis many times on the SGEM since 2012.

Sepsis 40

Sepsis Emergency Department COPD Hospitals 40

EMDocs

JUNE 15, 2024

. #2: From the Doorway – How Accurate Is Physician Gestalt in Sepsis? Spoon Feed Physician gestalt significantly outperformed existing sepsis screening tools (SIRS, qSOFA, SOFA, and MEWS) in identifying sepsis early in critically ill, undifferentiated patients’ ED courses. JAMA Netw Open. 2024 Apr 1;7(4):e247373.

Sepsis 76

Sepsis Emergency Department 76

EB Medicine

FEBRUARY 1, 2024

Eckler MD interview Nick Harrison, MD and Daniel Brenner, MD, two of the authors of the February 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Right Heart Failure Pathophysiology Presenting Symptoms Differential Diagnosis Specific Acute Causes PE Sepsis RVMI PPV ARDS COVID-19 Specific Chronic Causes CTEPH (..)

Emergency Department 98

Emergency Department Sepsis EKG/ECG 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 Dehydration EMS 52

ACEP Now

NOVEMBER 7, 2024

If you work in the emergency department, you’re out there in the trenches “suspecting sepsis” on a daily basis. Nearly 95 percent of the 2,511 patients included in this trial were enrolled in the emergency department, with the most common sources of infection suspected to be intra-abdominal or pulmonary.

Sepsis 64

Sepsis Infectious Diseases Outcomes Emergency Department 64

PHEM Cast

APRIL 10, 2016

[link] We hope you enjoyed our sepsis podcast. It is obviously a huge topic and there is lots of information to cover; a couple of other recently released podcasts are available which are produced with the Emergency Medicine community in mind, but will no doubt expand your knowledge. St Emlyns Induction podcast on Sepsis.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

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.

Resuscitation 98

Resuscitation Burns Emergency Department Sepsis 98

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

EM Literature of Note

OCTOBER 9, 2024

This exploration of LLMs in the emergency department is a bit unique in its conceptualization. emergency departments are general cesspools of aggressive empiric antibiotic coverage, driven by CMS regulations – so it may in fact be the LLM displaying astute clinical judgement, here. For what its worth, of course, U.S.

Radiology 84

Radiology Radiology Emergency Department Documentation/Coding 84

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

EMDocs

MAY 18, 2024

Post-Vaccination Fever in Infants Spoon Feed Serious bacterial infections were exceedingly rare in this study of recently immunized infants 6-12 weeks presenting to the emergency department with a fever. Source Serious bacterial infection risk in recently immunized febrile infants in the emergency department. 2024.03.025.

Emergency Department 52

Emergency Department Sepsis Pediatrics 52

EB Medicine

JANUARY 3, 2023

In this episode, Sam Ashoo, MD, interviews Ara Festekjian, MD, one of the authors of the November 2022 Pediatric Emergency Medicine Practice article on Pediatric Septic Shock in the Emergency Department Introduction: How common is sepsis in kids and what is the mortality rate in the US?

Shock 52

Shock Pediatrics Airway Management Sepsis 52

The Skeptics' Guide to EM

OCTOBER 14, 2023

Case: A 5-year-old boy presents to the emergency department (ED) with his parents for fever and fatigue. We have been reading online about something called sepsis that can be deadly. Does he have sepsis?” Specifically, heart rate and respiratory rates are used in early attempts to detect sepsis.

Pediatrics 86

Pediatrics Sepsis Urgent Care Emergency Department 86

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 73

Sepsis Outcomes Pediatrics Documentation/Coding 73

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 67

Emergency Department Pediatrics Sepsis Resuscitation 67

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. This can be the result of hypotension, tachycardia, sepsis, PE, etc. This can be the result of hypotension, tachycardia, sepsis, PE, etc.

Emergency Department 40

Emergency Department Shock EKG/ECG Sepsis 40

Broome Docs

JUNE 20, 2023

This episode covers herbs that may heal sepsis, drugs that probably don’t help in Covid, we ask: do steroids help in pneumonia? There are a lot of ideas to keep your brain up to date with the latest evidence in Emergency medicine. Intravenous Haloperidol Has a Limited Role in the Modern Emergency Department.

Emergency Department 132

Emergency Department Sepsis Best Practices 132

The Skeptics' Guide to EM

NOVEMBER 23, 2024

Dennis Ren is a pediatric emergency medicine physician at Children’s National Hospital in Washington, DC. Case: A 10-year-old boy presents to the community emergency department (ED) with abdominal pain. He’s also the host of SGEMPeds. It started last night but the pain seemed to worsen this morning.

Pediatrics 74

Pediatrics Sepsis Academics Emergency Department 74

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

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. Paediatr Anaesth. doi: 10.1111/pan.14185.

Pediatrics 183

Pediatrics Emergency Department Outcomes Sepsis 183

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

University of Maryland Department of Emergency Med

JANUARY 23, 2023

An Uncommon Cause of Shock Sepsis is the most common cause of distributive shock encountered in the emergency department and intens. Click to view the rest

Shock 40

Shock Sepsis Emergency Department 40

Taming the SRU

AUGUST 27, 2024

Mortality rates related to bullous skin lesions are typically related to disruption of the skin barrier and include subsequent dehydration, electrolyte imbalances, hypothermia, increased metabolic needs, and secondary infection leading to bacteremia and/or sepsis. What can you do from the Emergency Department if suspected?

Emergency Department 83

Emergency Department Dehydration Burns Sepsis 83

EMDocs

AUGUST 24, 2023

Study design Multicenter prospective observational cohort study across seven urban emergency departments. Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis: A Diagnostic Study. Reference: Cheng MP, Stenstrom R, Paquette K, et al. Ann Intern Med.

Administration 70

Administration Sepsis Shock Outcomes 70

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.

Emergency Department 68

Emergency Department Blood Transfusions Resuscitation Sepsis 68

Pediatric EM Morsels

FEBRUARY 2, 2024

Internationally Acquired Severe Systemic Infections in Febrile Pediatric Travelers Presenting to the Emergency Department. Pediatr Emerg Care. However, the destination of travel is also important as helminths have distinct geographical distribution. 2021 Dec 1;37(12):e1315-e1320.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

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

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

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 57

Sepsis Shock Hyperthermia / Hypothermia Administration 57

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

Don't Forget the Bubbles

MAY 31, 2023

Children presenting with diabetes and diabetic ketoacidosis to Emergency Departments during the COVID-19 pandemic in the UK and Ireland: an international retrospective observational study. During the COVID-19 pandemic , we noticed a change in the type of patients presenting to the Emergency Department. Arch Dis Child.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

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. Hemoglobin and platelets are helpful if HUS is suspected.

Emergency Department 40

Emergency Department Dehydration Poisoning 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 Wellness 60

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. The patient was given aspirin and heparin. While preparing for transport the patient became ashen and confused with cool and clammy skin and a very weak pulse.

EKG/ECG 126

EKG/ECG Shock Emergency Department Ambulance Services 126