RebelEM

AUGUST 14, 2023

Background: Could Xuebijing (XBJ) catalyze a paradigm shift in sepsis management? XBJ is an herbal compound used in China to manage various inflammatory and infectious processes in recent years, including sepsis. This post evaluates the recent “Efficacy of Xuebijing Injection in Patients With Sepsis (EXIT-SEP)” trial.

Sepsis 97

Sepsis Outcomes Administration EMS 97

EMDocs

JUNE 22, 2024

We’ll keep it short, while you keep that EM brain sharp. According to EMS, she was in labor at home and delivered the newborn shortly after they had loaded her into the ambulance. .” “Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation.” link] j.ajog.2016.03.012

EMS 111

EMS Resuscitation Blood Transfusions Seizures 111

RebelEM

MAY 18, 2023

REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension Click here for Direct Download of the Podcast Paper: The National Heart, Lung and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network. Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4

Sepsis 99

Sepsis Shock Resuscitation Outcomes 99

EMDocs

JULY 13, 2024

We’ll keep it short, while you keep that EM brain sharp. This patient appears septic and recently underwent a cesarean section delivery, which makes hospital admission and parenteral antibiotics the better choice for management. Incidence, treatment and outcome of peripartum sepsis. Am J Obstet Gynecol. 1985 Dec 1;153(7):737-9.

OB/GYN 84

OB/GYN EMS Sepsis Fluid Resuscitation 84

EMDocs

JULY 29, 2023

We’ll keep it short, while you keep that EM brain sharp. 2021.3.51501 The post EM@3AM: Suppurative Parotitis appeared first on emDOCs.net - Emergency Medicine Education. A 75-year-old male with past history of HTN, CVA, DM II presents to the emergency department with right facial swelling since last night. Afr J Paediatr Surg.

EMS 93

EMS Dehydration Ultrasounds Emergency Department 93

EMDocs

JULY 1, 2023

We’ll keep it short, while you keep that EM brain sharp. Patients should be admitted to the hospital and cardiology consulted early in their course. Kawasaki disease: two case reports from the Aga Khan Hospital, Dar es Salaam-Tanzania. The Royal Children’s Hospital Melbourne. cm, mucous membrane involvement (e.g.

EMS 87

EMS Infectious Diseases Pediatrics Research 87

PHEM Cast

APRIL 10, 2016

[link] We hope you enjoyed our sepsis podcast. St Emlyns Induction podcast on Sepsis. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. March 2016.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

RebelEM

MAY 29, 2023

Background: Sepsis can induce numerous physiologic derangements. It also reduced length of stay in ICU and hospital without adverse effects. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e. septic shock). 95% CI 15.4

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

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. Methods This was a prospective observational study enrolling all patients who presented to the ED through the lobby and via EMS.

Hospitals 88

Hospitals Emergency Department EMS Outcomes 88

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. Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial.

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

RebelEM

SEPTEMBER 21, 2023

Type 2 MI is common in the ED and can result from vigorous exercise (common in athletes after marathons), sepsis, trauma and tachydysrhythmias including SVT. appeared first on REBEL EM - Emergency Medicine Blog. Type 4: MI associated with percutaneous coronary intervention (Subtype 4a), or stent thrombosis (Subtype 4b).

EKG/ECG 143

EKG/ECG Sepsis EMS Outcomes 143

EMDocs

AUGUST 17, 2023

The study was performed when Surviving Sepsis Campaign Guidelines were used, so it was more common to see large volume fluid administration in the setting of sepsis. Welcome back to the “52 in 52” series. This collection of posts features recently published must-know articles. Today we look at the CENSER trial. vs 48.4% (OR 3.4,

Sepsis 88

Sepsis Shock Resuscitation Fluid Resuscitation 88

Critical Care Now

AUGUST 18, 2024

ClinicalTrials.gov: NCT025174897 Background: Community-acquired pneumonia (CAP) can lead to significant pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and increased mortality. Check out the full post on REBEL EM: [link] New guidelines from SCCM strongly support its use.

Outcomes 93

Outcomes Sepsis Administration EMS 93

EMDocs

NOVEMBER 27, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

EMS 93

EMS Sepsis Burns EKG/ECG 93

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. We have a special episode for you this month… We’ve brought Dr. Jeremy Rose, one of the peer reviewers, and a sepsis expert, on with us to talk through the content this month. Jeff : Sepsis chair. We like it that way.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

NOVEMBER 1, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

Operations 88

Operations Radiology Radiology Fluid Resuscitation 88

The Skeptics' Guide to EM

FEBRUARY 23, 2019

Association Between Early Intravenous Fluids Provided by Paramedics and Subsequent In-Hospital Mortality Among Patients With Sepsis. Association Between Early Intravenous Fluids Provided by Paramedics and Subsequent In-Hospital Mortality Among Patients With Sepsis. Date: February 22nd, 2019 Reference: Lane et al.

Sepsis 52

Sepsis Administration Documentation/Coding Hospitals 52

RebelEM

JULY 17, 2023

PMID: Clinical Question: Does a single dose of ketamine or etomidate used for rapid sequence intubation (RSI) of critically adults in the ED impact the SOFA score within 3 days of hospitalization? 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 93

Outcomes Emergency Department Administration Resuscitation 93

Taming the SRU

MARCH 10, 2024

There are also many costs to hypoglycemia, both in terms of financial burdens on hospitals/caretakers/patients, and in terms of morbidity and mortality. critical AS, ASD, HCM) Arrhythmogenic right ventricular cardiomyopathy Pulmonary embolism Thoracic aortic dissection Transient occult shock Sepsis Hemorrhagic shock (ex.

EKG/ECG 97

EKG/ECG Shock Wellness EMS 97

RebelEM

JANUARY 29, 2024

appeared first on REBEL EM - Emergency Medicine Blog. in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 133

Stroke Outcomes Hospitals Administration 133

Don't Forget the Bubbles

MAY 17, 2023

The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. Original clinical studies The impact of the early onset neonatal sepsis calculator on antibiotic initiation: a single center study in Israel. Levi M, et al.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Don't Forget the Bubbles

JUNE 30, 2023

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. But this was all done in adults, and no comparable prospective trials in children exist.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

The Skeptics' Guide to EM

JUNE 6, 2020

Max is then going to Georgetown to be an attending in both EM and ICU. Background: I think we have covered sepsis more often than any other topic on the SGEM. Max Hockstein trained as an Emergency Medicine physician at University of Texas Southwestern and is finishing his Intensive Care fellowship at Emory.

Sepsis 52

Sepsis Shock Resuscitation Administration 52

The Skeptics' Guide to EM

JANUARY 25, 2020

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. Case: A 60-year-old male is in your emergency department with sepsis from pneumonia. Date: January 9th, 2020 Reference: Casey et al.

EMS 40

EMS Airway Management Administration Resuscitation 40

RebelEM

AUGUST 12, 2024

Hospitals should be cautious in deciding to put their efforts towards them when the data from this trial has actually shown that it works in a diversified patient population such as that which exists in the United States.

Outcomes 81

Outcomes Hospitals Operations Shock 81

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The patient was extubated on Day-3 of the hospital stay. The patient improved, and on Day-11 of the hospital stay — he was off inotropes and on a small dose of a ß-blocker. The below ECG was recorded.

EKG/ECG 132

EKG/ECG Shock Hospitals Sepsis 132

The Skeptics' Guide to EM

JULY 16, 2022

Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. Paul Marik got the critical care world all excited when he claimed a Vitamin C cocktail (Vitamin C, hydrocortisone and thiamine) as a possible cure for sepsis.

Sepsis 40

Sepsis Shock Outcomes EMS 40

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. Dexamethasone and length of hospital stay in patients with community-acquired pneumonia: a randomised, double-blind, placebo-controlled trial.

Research 94

Research Outcomes Administration Shock 94

The Skeptics' Guide to EM

OCTOBER 3, 2021

Case: A 66-year-old woman is brought in by EMS from home with lethargy and hypotension. In the non-blinded SMART trial, there was no statistical difference in the individual components of the composite outcome (in-hospital death before 30 days, new renal replacement therapy or in creatinine >200% of baseline).

Outcomes 52

Outcomes Sepsis Administration Resuscitation 52

EMDocs

MARCH 4, 2024

Authors: Amelia Campbell, MD (EM Resident Physician, Carl R. Darnall Army Medical Center) and Alec Pawlukiewicz, MD (EM Attending Physician, Carl R. Now it is typically only employed if therapeutic procedures are anticipated, such as in patients with sepsis due to ascending cholangitis requiring biliary intervention for source control.

Emergency Department 104

Emergency Department Ultrasounds EMS Radiology 104

PEMBlog

AUGUST 20, 2024

ECPR involves using ECMO (Extracorporeal Membrane Oxygenation) to take over heart and lung functions, offering a last-resort option that is becoming more common in large pediatric hospitals. The episode highlights the importance of understanding eCPR as a critical therapy for both in-hospital and out-of-hospital cardiac arrests.

CPR 52

CPR Resuscitation Pediatrics Hospitals 52

EB Medicine

JANUARY 10, 2020

In-hospital mortality rates are about the same for STEMI and NSTEMI, about 10%. This can be the result of hypotension, tachycardia, sepsis, PE, etc. Part 4: Pre-hospital care Prehospital ECGs decrease time to intervention. In-hospital mortality rates are about the same for STEMI and NSTEMI, about 10%. *

Emergency Department 40

Emergency Department Shock EKG/ECG Sepsis 40

All Ohio EM

OCTOBER 26, 2018

Among patients who survive one day on ECMO, 2/3 walk out of the hospital neurologically intact. Corey Slovis would be horrified that I’m not listing 5 things for him, but the one pearl I wanted to emphasize: refractory acidosis in DKA, think abscess, sepsis, or dead gut. no terminal conditions or DNR. All great stuff.

CPR 52

CPR Sepsis Stroke EMS 52

RebelEM

FEBRUARY 2, 2023

Average time control HR in the amiodarone group was on par with the study’s average ED length of stay Limitations: Single center, retrospective hospital study may not be able to produce generalizable results. Sepsis, hyperthyroidism, dehydration, heart failure, ACS, etc).

Emergency Department 52

Emergency Department Administration Dehydration EMS 52

Northwestern EM Blog

MAY 16, 2022

were hospitalizations during f/u period; 26.4% were hospitalizations during f/u period; 26.4% were hospitalizations during f/u period; 26.4% There also were no significant differences in pain scores, hospitalizations, ED readmissions among the groups. vs. US 31.2%

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

RebelEM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. 4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. J Crit Care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

Emergency Medicine Ireland

DECEMBER 24, 2020

The pathophys is challenging to study but one animal model we do have suggested renal blood flow actually increases initially with the hyperdynamic state of sepsis without histological signs of injury. References: Oh’s Manual Chapter 47 Tasty Morsels of EM 116

Sepsis 40

Sepsis Ultrasounds EMS Hospitals 40