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

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

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

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Shock Sepsis Emergency Department 40

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. This should be suspected in patients with intraoperative cardiac arrest or shock. units per patient. Plast Reconstr Surg. 2015;136(1):58-66.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

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

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

Pediatric Emergency Playbook

JUNE 1, 2016

Do we recognize shock early enough? World wide, shock is a leading cause of morbidity and mortality in children, mostly for failure to recognize or to treat adequately. So, what is shock? Simply put, shock is the inadequate delivery of oxygen to your tissues. How do we prioritize our interventions? Pericardial Effusion?

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Shock Sepsis Pediatrics Ultrasounds 40

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane).

Sepsis 94

Sepsis Fractures Documentation/Coding Administration 94

EMDocs

AUGUST 24, 2023

Study design Multicenter prospective observational cohort study across seven urban emergency departments. 18.6%) Takeaways: Drawing blood cultures 30-120 min and 30-240 min after antibiotics has significant decrements in the rate of culture positivity in patients with septic shock. Difference of 12% (95% CI 5.4 Ann Intern Med.

Administration 70

Administration Sepsis Shock Outcomes 70

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. Intravenous 0.9%

Dehydration 52

Dehydration Fluid Resuscitation Administration Resuscitation 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.

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Shock Emergency Department Pediatrics EKG/ECG 96

The Skeptics' Guide to EM

FEBRUARY 24, 2018

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. He writes an […] The post SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock first appeared on The Skeptics Guide to Emergency Medicine. Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. NEJM January 2018.

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Shock Sepsis Emergency Department Resuscitation 40

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?

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Sepsis Outcomes Pediatrics Documentation/Coding 75

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).

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Sepsis Shock Resuscitation Outcomes 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

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. MACE= Major Adverse Cardiovascular Event: including re-infarction, stroke, dysrhythmia, heart failure, cardiogenic shock, and death.

Emergency Department 40

Emergency Department EKG/ECG Shock Sepsis 40

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

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. ACS and STEMI generally do not cause tachycardia unless there is cardiogenic shock. Then ACS (STEMI) might be primary; this might be cardiogenic shock. The patient was suffering from severe dehydration, possibly with sepsis.

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

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.

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Sepsis Shock Administration Resuscitation 52

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

Carly Eastin is an Associate Professor, Division of Research and Evidence Based Medicine, Department of Emergency Medicine, University of Arkansas for Medical Sciences. Case: A 45-year-old female in the emergency department is being admitted to the intensive care unit (ICU) for septic shock secondary to urinary tract infection (UTI).

Sepsis 52

Sepsis Shock Outcomes Stroke 52

Don't Forget the Bubbles

JUNE 30, 2023

Ranulf went white with the shock. 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.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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. Nachi: Each year, in the US, approximately 10,000 patients present with electrical burns or shocks. That’s -- high.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

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. Neonatal Toxic Shock Syndrome C. Neonatal Toxic Shock Syndrome-Like Exanthematous Disease E. Neonatal toxic shock syndrome-like exanthematous disease (NTED).

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

Northwestern EM Blog

JANUARY 24, 2022

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

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Anaphylaxis Shock Sepsis Resuscitation 52

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

Taming the SRU

AUGUST 30, 2023

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. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear.

Infectious Diseases 87

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

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

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. IV hydration for patients with severe dehydration, hypovolemic shock, septic shock, or failed oral rehydration.

Emergency Department 40

Emergency Department Dehydration Poisoning Allergic Reactions 40

The Skeptics' Guide to EM

JANUARY 15, 2022

Intensive Care Med 2021 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a professor of Emergency Medical Services at Tacoma Community College’s paramedic program. Both agents are considered hemodynamically stable, but any induction agent may precipitate shock in the critically ill.

Sepsis 43

Sepsis Shock Emergency Department Outcomes 43

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

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

The Skeptics' Guide to EM

JULY 16, 2022

Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. Rezaie completed his medical school training at Texas A&M Health Science Center and continued his medical education with a combined Emergency Medicine/Internal Medicine residency at East Carolina University. Date: July 16th, 2022 Reference: Lamontagne F et al.

Sepsis 40

Sepsis Shock Outcomes EMS 40

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. 1,2 Teaching points: Scrotal pyocele can mimic other testicular etiologies, but should always be included in the differential, as it is a urologic emergency. J Emerg Trauma Shock.

Urgent Care 52

Urgent Care Ultrasounds Sepsis Emergency Department 52

Don't Forget the Bubbles

JULY 5, 2023

Symptoms may be non-specific in the beginning with patients quickly developing septic shock and disseminated intravascular coagulation. Vaccination: PCV13 (pneumococcal vaccination), meningococcal vaccines, and Hib conjugated vaccines are important to prevent life-threatening sepsis. Pneumococcal sepsis B. Pneumococcal sepsis.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

RebelEM

OCTOBER 5, 2023

Background: Community-acquired pneumonia (CAP) can lead to pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and an increased risk of death. About 25% of the excluded patients had septic shock, but the classification of hypotension as septic shock was at the discretion of the treating team.

Research 94

Research Outcomes Administration Shock 94

The Skeptics' Guide to EM

FEBRUARY 10, 2018

Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. Case: Tom is a 4-year-old boy who comes into the emergency department with a wheeze following a viral illness. He has been taking salbutamol at home today but he’s still not improving.

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

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