RebelEM

NOVEMBER 30, 2023

For those with sepsis, the administration of intravenous fluids (IVF) at the volumes recommended in the Surviving Sepsis Campaign (SSC) requires careful consideration of an individual’s chronic medical conditions and subsequent sensitivity to IVF. Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Am J Emerg Med.

Sepsis 122

Sepsis Fluid Resuscitation Resuscitation Administration 122

The Trauma Pro

AUGUST 16, 2024

This one applies to anyone who takes care of children, and is particularly important to EMS / prehospital providers and emergency physicians. Bottom line: It’s so easy to go down the sepsis path with sick kids, especially those who can’t talk yet. And another law to end the first week! Any time I give a pediatric talk, I mention it.

Pediatrics 203

Pediatrics Sepsis EMS 203

EMDocs

OCTOBER 19, 2024

We’ll keep it short, while you keep that EM brain sharp. Blood cultures: Blood cultures are rarely positive; however, should be obtained if suspicion for sepsis is present or if the patient is immunocompromised. [2][3] link] The post EM@3AM: Bacterial Tracheitis appeared first on emDOCs.net - Emergency Medicine Education.

EMS 110

EMS Pediatrics Sepsis Airway Management 110

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

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 98

Sepsis Outcomes Administration EMS 98

EMDocs

DECEMBER 18, 2024

Upon EMS arrival the male is noted to be anxious and tremulous with a GCS of 14. A 36-year-old male presents to the emergency department after being found down at home by his spouse. Per the mans wife, the patient is a heavy drinker often consuming two to three pints of vodka daily.

Seizures 105

Seizures Hyperthermia / Hypothermia Emergency Department EMS 105

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 104

Sepsis Shock Resuscitation Outcomes 104

EMDocs

MAY 11, 2024

We’ll keep it short, while you keep that EM brain sharp. A 74-year-old female with a past medical history of hypertension, diabetes, recent basilar artery stent placement with a 20 pack-year smoking history presents to the ED via EMS for altered mental status and episodes of apnea. Vital signs include BP 168/89, HR 96, T 98.3,

Stroke 110

Stroke EMS EKG/ECG Radiology 110

EMDocs

JULY 13, 2024

We’ll keep it short, while you keep that EM brain sharp. Incidence, treatment and outcome of peripartum sepsis. The post EM@3AM: Endometritis appeared first on emDOCs.net - Emergency Medicine Education. Am J Obstet Gynecol. 1985 Dec 1;153(7):737-9. doi: 10.1016/0002-9378(85)90335-7. PMID: 4073137. Acta Obstet Gynecol Scand.

OB/GYN 89

OB/GYN EMS Sepsis Fluid Resuscitation 89

Pediatric EM Morsels

MARCH 29, 2024

link] The post Rebaked: Inborn Errors of Metabolism presenting in the ED appeared first on Pediatric EM Morsels. Inborn Errors of Metabolism: Becoming Ready for Rare. Samantha A. Schrier Vergano. Pediatr Rev (2022) 43 (7): 371–383.

Dehydration 297

Dehydration Pediatrics Sepsis EMS 297

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 96

EMS Dehydration Ultrasounds Emergency Department 96

EMDocs

JULY 1, 2023

We’ll keep it short, while you keep that EM brain sharp. link] The post EM@3AM: Kawasaki Disease appeared first on emDOCs.net - Emergency Medicine Education. A 3-year-old male with no past medical history presents to the ED with one week of daily fevers >102°F associated with four days of rash on the trunk. UpToDate;2022.

EMS 92

EMS Infectious Diseases Pediatrics Research 92

Emergency Medicine Cases

MARCH 1, 2022

The post EM Quick Hits 36 – Surviving Sepsis, Angle Closure Glaucoma, Bougies, Frostbite, Hot/Altered Patient, Central Cord Syndrome appeared first on Emergency Medicine Cases.

Sepsis 52

Sepsis EMS Fluid Resuscitation Hyperthermia / Hypothermia 52

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

JULY 5, 2023

Sepsis) De Winters T waves are the earliest sign of an anterior wall MI but will only be present in ~ 2% of LAD infarcts Patients with Wellens Syndrome on ECG should have a cardiac cath within 24 hours, not necessarily within the first 60 minutes of ED arrival.

EKG/ECG 134

EKG/ECG Sepsis EMS 134

RebelEM

FEBRUARY 19, 2024

The 2021 Surviving Sepsis Campaign Guidelines suggest starting vasopressors peripherally rather than delaying infusion until a CVC is placed [2]. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. REBEL EM: Peripheral Vasopressors – Safe or Dangerous?

Administration 137

Administration Sepsis EMS Shock 137

Dr. Smith's ECG Blog

JANUARY 2, 2025

She was managed for sepsis with antibiotics including azithromycin, had hypotension with arterial and central lines placed and pressors. I do not see OMI here and all trops were only minimally elevated, consistent with either chronic injury from cardiomyopathy or with acute injury from sepsis. Dodd KW, Elm KD, Dodd EM, Smith SW.

EKG/ECG 116

EKG/ECG Sepsis Wellness Documentation/Coding 116

Emergency Medicine Cases

MAY 5, 2020

The post EM Quick Hits 18 Conservative Management Pneumothorax, Microdosing Buprenorphine, Practical Use of CRITOE, Canadian TIA Score, Pediatric Surviving Sepsis Guidelines, Safety of Peripheral Vasopressors appeared first on Emergency Medicine Cases.

Sepsis 52

Sepsis Pediatrics EMS Fractures 52

RebelEM

MAY 29, 2023

Background: Sepsis can induce numerous physiologic derangements. The Influence of Methylene Blue infusion on Cytokine Levels During Severe Sepsis. appeared first on REBEL EM - Emergency Medicine Blog. septic shock). NaCl over 6hrs once daily x3 doses Placebo: 500mL of 0.9% 95% CI 15.4 95% CI 15.4 vs 0.5% (Range 0.4

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

Emergency Medicine Cases

MARCH 26, 2019

In this podcast Dr. Sara Gray, intensivist and emergency physician, co-author of The CAEP Sepsis Guidelines, answers questions such as: How does one best recognize occult septic shock? What are the goals of resuscitation in the patient with sepsis or septic shock? What are the indications for a second vasopressor after norepinephrine?

Sepsis 40

Sepsis Shock EMS Resuscitation 40

EMDocs

SEPTEMBER 6, 2023

Learning points: Consider differential – sepsis, thyroid storm, thalamic stroke, exertional and classic heat stroke, serotonin syndrome, neuroleptic malignant syndrome, sympathomimetic toxicity, and anticholinergics. Reference: EM@3AM – Heat Stroke Case 2: 40-year-0ld female feels unwell but no other specific complaints.

Anaphylaxis 96

Anaphylaxis Shock Sepsis Stroke 96

RebelEM

APRIL 26, 2023

Remember to evaluate for concurrent medical illness: gastritis, pancreatitis, pyelonephritis, pneumonia, sepsis. Remember to evaluate for concurrent medical illness: gastritis, pancreatitis, pyelonephritis, pneumonia, sepsis. Treatment consists of thiamine, dextrose, and volume repletion. The syndrome of alcoholic ketoacidosis.

Sepsis 130

Sepsis Administration EMS 130

Emergency Medicine Cases

SEPTEMBER 12, 2023

The post EM Quick Hits 51 – Methylene Blue in Septic Shock, TMJ Dislocation, Crohn’s Disease, Analgesia for Renal Colic, Inhaled Steroids for Asthma, Hypocalcemia in Bleeding Trauma Patients appeared first on Emergency Medicine Cases.

Dislocations 91

Dislocations Shock EMS Sepsis 91

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 93

Sepsis Shock Resuscitation Fluid Resuscitation 93

Pediatric EM Morsels

NOVEMBER 17, 2023

The post Cuffed Endotracheal Tubes for Children: ReBaked Morsel appeared first on Pediatric EM Morsels. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). Acad Emerg Med. 2022 Apr;29(4):406-414. doi: 10.1111/acem.14431. 2016 Feb;30(1):3-11.

Pediatrics 187

Pediatrics Emergency Department Outcomes Sepsis 187

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

First 10 EM

JULY 3, 2023

I think there is an interesting variety of papers this time around, from sepsis, to b t, to patient access to their own results online. The pace of these literature summaries has decreased over the years, but perhaps that means that quality has increased?

Research 102

Research Sepsis EMS 102

Emergency Medicine Cases

OCTOBER 17, 2023

In this ECG Cases blog Dr. Jesse McLaren guides us through 10 cases, driving home the points that sepsis is a common cause of rapid Afib and diffuse ST depression with reciprocal ST elevation in aVR, myo/pericarditis is a diagnosis of exclusion, endocarditis or lyme carditis can cause AV block, PE can cause low grade fever and ECG signs of acute RV (..)

Infectious Diseases 101

Infectious Diseases EKG/ECG Sepsis EMS 101

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 96

EMS Sepsis Burns EKG/ECG 96

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

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. Sepsis-3!!

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 93

Operations Radiology Radiology Fluid Resuscitation 93

RebelEM

FEBRUARY 8, 2024

PMID: 32109843 For More Thoughts on This Topic Checkout: REBEL EM: Is ATLS Wrong About Palpable Blood Pressure Estimates? appeared first on REBEL EM - Emergency Medicine Blog. to 1.12; p = 0.03 for every change in 5ug/min Lower MAP Value: aOR 0.98; 95% CI 0.98 to 0.99; p <0.01 to 1.09; p = 0.01 to 1.37; p <0.01 to 2.47; p – 0.04

Resuscitation 123

Resuscitation Outcomes EMS Sepsis 123

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

EMergucate

MAY 17, 2016

Blood Cultures Cellulitis Dengue Fever HIV Human Herpes Viruses Infection Control Lyme Disease Malaria Needlestick Notifiable Diseases SARS Sepsis STDs … Continue reading →

Infectious Diseases 40

Infectious Diseases EMS Sepsis 40

Pediatric EM Morsels

APRIL 7, 2023

Unfortunately, it can cause so many other complications – Sepsis , acute chest syndrome , and hepatopathy. The post Sickle Cell Disease and Stroke appeared first on Pediatric EM Morsels. Stroke in patients with sickle cell disease. Expert Rev Hematol. 2013 Jun;6(3):301-16. doi: 10.1586/ehm.13.25. PMID: 23782084.

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

EM Curious

JULY 29, 2015

The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world that you can fit into your busy weekly schedule. Over a year's span we will be sure to include topics from all core EM content areas.even the ones that may not be the coolest. Read the post from EM Nerd here.

Sepsis 52

Sepsis EMS Emergency Department Ultrasounds 52