Taming the SRU

AUGUST 27, 2024

This differential is broad and reflects the clinical diversity of their presentations - in this post we will parse through the specifics of bullous lesions as well as what there is to do for them acutely. What can you do from the Emergency Department if suspected? What can you do from the Emergency Department if suspected?

Emergency Department 82

Emergency Department Dehydration Burns Sepsis 82

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

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.

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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. PMID: 25261506 Khan MA, Rosenberg MG, Fein DM, Quezada XH, Reingold RE, Tadros FK, Wolnerman YY, Yao JY, Schneider C, Meltzer JA. 2021 Dec 1;37(12):e1315-e1320.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

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. Tachycardia may be present both from many medications or drugs, as well as withdrawal. Ann Emerg Med. Acad Emerg Med. Ann Emerg Med.

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Shock Emergency Department Pediatrics EKG/ECG 94

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

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.

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Emergency Department Research Documentation/Coding Outcomes 135

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

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.

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Sepsis Shock Administration Resuscitation 52

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. Yet policies mostly escape this challenge. It seems all a policy needs is a strong champion and plausibility.

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Outcomes Research Sepsis Emergency Department 113

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. Jeff: Well that’s kind worrisome. Which again reiterates why this is such an important topic for us as EM clinicians to be well-versed in.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

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.

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EKG/ECG Shock Emergency Department Ambulance Services 125

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.

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Pediatrics Hyperthermia / Hypothermia Emergency Department Urgent Care 52

ACEP Now

MAY 10, 2024

Patients with flank pain (which would suggest pyelonephritis) as well as patients meeting two or more SIRS criteria (which would suggest sepsis) comprise a higher risk group. For simplicity, we will focus only on the patients with suspected lower urinary tract infection (UTI).

Infectious Diseases 98

Infectious Diseases Sepsis Administration Emergency Department 98

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: Vascular injuries include coagulation necrosis as well as thrombosis. Jeff: You’re right.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

PEMBlog

OCTOBER 18, 2023

The night prior to presentation, mom noticed he was not feeding as well and seemed fussy. Initially in the emergency department he was generally well-appearing with normal vital signs. rectally, prompting a sepsis workup given his age. This patient was hospitalized for 4 days where he remained well-appearing.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

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.

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Sepsis Emergency Department Seizures Pediatrics 52

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. Pulses are well felt in all four limbs. as seen in heart failure, arrhythmias, or sepsis). J Am Coll Cardiol.

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EKG/ECG Emergency Department Burns Wellness 110

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. 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. ng/mL, 0.25-0.5

Infectious Diseases 87

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

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

PEMBlog

MARCH 27, 2024

This episode will help you better prepare for and manage children with inborn errors of metabolism in the Emergency Department. Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast. Or, well, the ringer called me.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

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. Got FDA exemption as well as went to the community and made sure their community was ok with the trial). Range 5 to 9) Etomidate: 7.0 95% CI -1.4

Outcomes 98

Outcomes Administration Emergency Department Resuscitation 98

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane).

Sepsis 94

Sepsis Documentation/Coding Administration Fractures 94

PEMBlog

AUGUST 20, 2024

These could include severe sepsis. eCPR is typically performed in specialized centers with highly trained personnel in well coordinated teams. For instance, eCPR is well established as a bridge therapy in pediatric patients with congenital heart disease and increasingly used in in hospital cardiac arrests.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

Taming the SRU

JULY 24, 2023

THE CASE A male in his 60s presented to the emergency department for right upper quadrant abdominal pain. Risk factors associated with increased risk of acute perforated cholecystitis include age greater than 65 years old, as well as diabetes mellitus, atherosclerosis, or organ failure (1, 2).

Ultrasounds 77

Ultrasounds Sepsis Radiology Radiology 77

EMDocs

NOVEMBER 27, 2023

A 55-year-old male, with a previous medical history of hypertension, hyperlipidemia, and gout, presents to the emergency department for four days of fever and progressive rash. This series provides evidence-based updates to previous posts so you can stay current with what you need to know.

EMS 71

EMS Sepsis Burns EKG/ECG 71

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

PEMBlog

JANUARY 17, 2024

Transcript Note: This transcript was partially completed with the use of the Descript AI  Welcome to another episode of PEM Currents, the Pediatric Emergency Medicine Podcast. You can also see petechiae and hemorrhage, as well as superficial bulla, vesicles, or even echemosis. Full blown sepsis and toxic shock syndrome.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

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. Acidosis Acidosis in shock states can present from multiple different sources, including sepsis, hypoxemia, ingestions, hyperlactatemia from hypoperfusion, amongst others. 3) Farkas J.

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Anaphylaxis Shock Sepsis Resuscitation 52

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 West J Emerg Med. Am J Emerg Med. Acad Emerg Med. Ladde JG, Miller S, Chin K, et al.

Hospitals 87

Hospitals Emergency Department EMS Outcomes 87

Don't Forget the Bubbles

JUNE 30, 2023

You will be running the show today, and you want to use your preparation time well. 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. The trauma call goes out.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Don't Forget the Bubbles

JULY 17, 2023

Evaluating the Impact of the 2017 Dutch Neonatal Early-Onset Sepsis Guideline. 2023 Jun 1;76(6):731-736 The Association Between Media-Based Exposure to Nonsuicidal Self-Injury and Emergency Department Visits for Self-Harm. Prenatal opioid exposure and well-child care in the first 2 years of life: population-based cohort study.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

Broome Docs

APRIL 6, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. A prospective cluster-randomized trial to implement the Canadian CT Head Rule in emergency departments. N Engl J Med. 2023 Jan 21. doi: 10.1056/NEJMoa2212663. Epub ahead of print. PMID: 36688507 You can read Justin’s Full write up here.

Sepsis 52

Sepsis Ultrasounds Hospitals Outcomes 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? Well, this may not be completely true.

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

EMDocs

DECEMBER 18, 2023

Introduction Sepsis and septic shock are life-threatening conditions characterized by severe systemic inflammation and organ dysfunction due to a dysregulated host response to infection. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician.

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Sepsis Fluid Resuscitation Resuscitation Shock 65

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

The Skeptics' Guide to EM

FEBRUARY 24, 2018

Case: 64-year-old male presents to your emergency department with worsening abdominal pain, nausea, vomiting and anorexia for the past week. Over the course of his emergency department stay he has escalating vasopressor requirements. He writes an excellent blog called EM Nerd , which he describes as nihilistic ramblings.

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Shock Sepsis Emergency Department Resuscitation 40