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 87

Dislocations Shock EMS Sepsis 87

EMDocs

MAY 31, 2023

Author: Walid Malki, MD ( @Wandering_ER ) // Reviewed by: Brit Long, MD (@long_brit); Alex Koyfman, MD (@EMHighAK) Welcome the Visual Wednesdays, a series that provides focused EM updates with infographics. The post Visual Wednesdays: Septic Shock Management appeared first on emDOCs.net - Emergency Medicine Education.

Shock 82

Shock EMS Sepsis 82

RebelEM

FEBRUARY 19, 2024

Background: Use of vasopressors is a common practice to support hemodynamics and optimization of tissue perfusion in patients presenting with shock. The 2021 Surviving Sepsis Campaign Guidelines suggest starting vasopressors peripherally rather than delaying infusion until a CVC is placed [2]. PMID: 37611862 Evans L et al.

Administration 137

Administration Sepsis EMS Shock 137

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 87

EMS Pediatrics Sepsis Airway Management 87

Emergency Medicine Cases

MARCH 26, 2019

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? Which fluid and how much fluid is best for resuscitation of the septic shock patients? What are the indications for a second vasopressor after norepinephrine?

Sepsis 40

Sepsis Shock EMS Resuscitation 40

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

Pediatric EM Morsels

FEBRUARY 2, 2024

PMID: 26368057 The post Travel-Related Illnesses in Children appeared first on Pediatric EM Morsels. However, the destination of travel is also important as helminths have distinct geographical distribution. Management of Children with Travel-related Illness Evaluated in a Pediatric Emergency Room. Pediatr Infect Dis J.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

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 71

Anaphylaxis Shock Sepsis Stroke 71

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

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 66

EMS Infectious Diseases Pediatrics Research 66

EMDocs

AUGUST 17, 2023

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% Today we look at the CENSER trial. vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 67

Sepsis Shock Resuscitation Fluid Resuscitation 67

RebelEM

FEBRUARY 8, 2024

Background: Patients with shock frequently present with hypotension. 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 to 0.99; p <0.01 to 1.09; p = 0.01 to 1.37; p <0.01

Resuscitation 126

Resuscitation Outcomes EMS Sepsis 126

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.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

Taming the SRU

MARCH 10, 2024

critical AS, ASD, HCM) Arrhythmogenic right ventricular cardiomyopathy Pulmonary embolism Thoracic aortic dissection Transient occult shock Sepsis Hemorrhagic shock (ex. Can’t miss ED diagnosis for syncope Brady/tachy dysrhythmia, arrhythmias such as ARVC, channelopathy (Brugada) Acute MI Structural heart disease (ex.

EKG/ECG 96

EKG/ECG Shock Wellness EMS 96

The Skeptics' Guide to EM

JUNE 6, 2020

Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Max is then going to Georgetown to be an attending in both EM and ICU. Date: June 2nd, 2020 Reference: Permpikul et al. Respir Crit Care Med 2019.

Sepsis 52

Sepsis Shock Resuscitation Outcomes 52

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.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 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. 2014 Sep;45(9):1287-95.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

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 67

Operations Radiology Radiology Fluid Resuscitation 67

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. She is admitted to the intensive care unit (ICU) for septic shock. A dozen top EM skeptics commented about the validity of the study. Guest Skeptic: Dr. Salim R.

Sepsis 40

Sepsis Shock Outcomes EMS 40

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

Stroke 136

Stroke Outcomes Hospitals Administration 136

EMergucate

APRIL 29, 2014

Issues: shock – bleeding (haematemesis), vomiting, sepsis jaundice – liver failure, cholangitis Sepsis Requires immediate concurrent resuscitation and investigation pH … Continue reading →

Sepsis 40

Sepsis Resuscitation Shock EMS 40

Critical Care Now

APRIL 26, 2022

Reading Time: 3 minutes Mohamed Hagahmed, MD, EMT-P Mohamed is an Emergency Medicine Physician and EMS director. When EMS arrived, they found the patient to be responsive only to painful stimuli and was moaning. A reduced supply of cortisol will decrease vascular tone, causing systemic vasodilation, shock, and hemodynamic collapse.

Resuscitation 52

Resuscitation Fluid Resuscitation EMS Sepsis 52

EMergucate

APRIL 1, 2014

He has severe sepsis (high temp, compensated shock). 67 year old man presents 7 days post major surgery critically unwell. … Continue reading →

Sepsis 40

Sepsis Shock EMS 40

EMergucate

JUNE 22, 2016

A critically unwell 17 year old with shock and sepsis Describe and Interpret: Normal anion gap metabolic acidosis HCO3 14, … Continue reading →

Sepsis 40

Sepsis Shock EMS 40

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 in today’s case presented in cardiogenic shock from proximal LAD occlusion, in conjunction with a subtotally stenosed LMCA. Written By Magnus Nossen — with edits by Ken Grauer and Smith.

EKG/ECG 122

EKG/ECG Shock Hospitals Sepsis 122

EMergucate

MAY 27, 2014

Critically unwell patient with shock requiring resuscitation 2. Severe Sepsis … Continue reading → Issues – 1. High glucose – HHS vs DKA 3.

Sepsis 40

Sepsis Resuscitation Shock EMS 40

RebelEM

AUGUST 12, 2024

2020 Mar 14; PMID: 32183395 Post Peer Reviewed By : Salim Rezaie, MD (Twitter/X: @Srrezaie ) The post The PROTECTION Trial – A Randomized Trial of Intravenous Amino Acids for Kidney Protection appeared first on REBEL EM - Emergency Medicine Blog.

Outcomes 81

Outcomes Hospitals Operations Shock 81

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

Taming the SRU

JULY 31, 2024

However, believers in this superstition will perceive crazier shifts if the word is uttered so you probably shouldn’t say it, or use cautiously Full moons have no impact on ED, EMS, or HEMS volumes or acuity. Nice people are not more likely to get cancer.

EKG/ECG 52

EKG/ECG Sepsis Documentation/Coding Stroke 52

EMDocs

JUNE 27, 2024

Sundd P, Gladwin MT, Novelli EM. smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 2 mcg/kg, max 100 mcg) while obtaining IV access 20 IV/IM ketorolac (1 mg/kg, max 15 mg) Morphine (05-0.1 mg/kg, max 0.4 2020 Feb 12;10(1):2470. Annu Rev Pathol.

Pediatrics 75

Pediatrics Dehydration EMS Hospitals 75

EB Medicine

JANUARY 10, 2020

MACE= Major Adverse Cardiovascular Event: including re-infarction, stroke, dysrhythmia, heart failure, cardiogenic shock, and death. This can be the result of hypotension, tachycardia, sepsis, PE, etc. 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

RebelEM

JANUARY 25, 2023

Rezaie, MD (Twitter: @srrezaie ) The post REBEL Core Cast 94.0 – SBO appeared first on REBEL EM - Emergency Medicine Blog. Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

EMergucate

NOVEMBER 12, 2017

A middle aged man presents critically unwell with features to suggest septic shock and cardiogenic shock Initial bloods: NAGMA with high … Continue reading →

Shock 40

Shock Sepsis EMS 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chest pain, weakness and nausea. En route, EMS administered aspirin 325mg by mouth, but withheld nitroglycerin due to initial hypotension. Answer below in the still shot.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

EMergucate

JULY 1, 2014

The stem suggests: severe sepsis ( vital signs show a SIRS response) Consider stage of cancer and intervention required. Risk … Continue reading →

Sepsis 40

Sepsis Shock EMS 40

EMergucate

JUNE 10, 2014

Critically unwell patient with septic shock Source – Respiratory, other 2. Breast Cancer Is patient on Chemotherapy – … Continue reading →

Shock 40

Shock Sepsis EMS 40

Don't Forget the Bubbles

OCTOBER 2, 2024

Soll RF, Edwards EM. Corticosteroids for Managing Pediatric Sepsis and Septic Shock: A Systematic Review and Meta-analysis. Even though this seems easy, there are potential barriers such as financial costs, messages delivered to divorced (i.e. Pediatrics. 2024 Sep 1;154(3):e2024066681. Ter Horst J, Rimensberger PC, Kneyber MCJ.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Urgent Care 52