ACEP Now

OCTOBER 29, 2024

For example, experienced emergency physicians have great clinical gestalt and accuracy to predict sepsis in critically ill patients at just 15 minutes from patient arrival—more so than scoring tools like the qSOFA, MEWs, and even machine-learning trained artificial intelligence models. Mary’s Hospital in Leonardtown, Maryland.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

EMDocs

AUGUST 17, 2023

The median amount of fluids administered between the groups before initiation of NE was not statistically significant (2080 mL vs. 1900 mL). 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.

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Sepsis Shock Resuscitation Fluid Resuscitation 95

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.

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Sepsis Hospitals Fluid Resuscitation Administration 40

EMDocs

JULY 13, 2024

A) Administer ceftriaxone 500 mg IM and doxycycline 100 mg PO B) Consult OB/GYN for incision and drainage C) Establish IV access and administer clindamycin and gentamicin D) Prescribe doxycycline with metronidazole and ensure close OB/GYN follow-up Answer: C Most postpartum infections are identified after hospital discharge. PMID: 4073137.

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OB/GYN EMS Sepsis Fluid Resuscitation 91

PulmCCM

FEBRUARY 28, 2022

Further, the treating clinician must have deemed either normal saline or balanced crystalloid as appropriate resuscitation options; the patient’s expected-admission to the ICU must have been at least 3 days. Other exclusions were imminent risk of death, life-expectancy less than 90 days, traumatic brain injury, risk of cerebral edema.

Fluid Resuscitation 40

Fluid Resuscitation Resuscitation Outcomes Sepsis 40

EMDocs

JUNE 22, 2024

“Amniotic fluid embolism: diagnosis and management.” “Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation.” The post EM@3AM: Amniotic Fluid Embolism appeared first on emDOCs.net - Emergency Medicine Education. ” Am J Obstet Gynecol 215(2): B16-24.

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EMS Resuscitation Blood Transfusions Seizures 111

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 95

Operations Radiology Radiology Fluid Resuscitation 95

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.

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Sepsis Shock Fluid Resuscitation Hospitals 40

The Skeptics' Guide to EM

JUNE 15, 2018

Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario.

Emergency Department 52

Emergency Department Fluid Resuscitation Hospitals Sepsis 52

Mind The Bleep

FEBRUARY 27, 2024

There could be any number of reasons for this but some examples are: they have severe D&V and aren’t keeping fluids down, or because they are pre or post-op, or have presented very unwell and need fluid resuscitation. How much fluid? saline + 5% dextrose or plasma-lyte 148 + 5% dextrose. 0 5 5 4 0 Calcium 2.1-2.6

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Fluid Resuscitation Hospitals Dehydration Research 96

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. 2021, Im, Kang et al.

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Sepsis Shock Administration Resuscitation 52

Mind The Bleep

DECEMBER 31, 2023

Hello, this is Dr so-and-so, renal SHO on call’ Depending on your hospital renal facilities, you are likely to only hold the renal bleep in F2 or above. pneumonia on top of chronic fluid overload / pulmonary oedema secondary to CKD) A pathology completely unrelated to their renal disease, but requiring renal input during admission (e.g.

Fluid Resuscitation 52

Fluid Resuscitation Hospitals Sepsis EKG/ECG 52

Northwestern EM Blog

FEBRUARY 14, 2022

ICU length of stay, hospital length of stay, ventilator-dependent days, or rate of renal replacement therapy: these are all things that matter to our patients and to our health systems and they are more fruitful targets when we investigate interventions.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

Mind The Bleep

FEBRUARY 9, 2024

Intensive care units provide the highest-level care for patients within the hospital. At most hospitals, the CCOT service is run by nurses and other advanced healthcare professionals who are very experienced in assessing and looking after unwell patients. Some respiratory wards offer NIV – some renal units offer dialysis.

Hospitals 52

Hospitals Resuscitation Fluid Resuscitation Shock 52

Taming the SRU

APRIL 3, 2023

Cardiac Arrest in Pregnancy 1 in 30,000 pregnancies 800 maternal deaths globally Rates have nearly doubled between 1989 and 2009 Survival to hospital discharge after maternal in-hospital cardiac arrest 58.9% Do not transport to an alternative location.

Blood Transfusions 40

Blood Transfusions Fluid Resuscitation Resuscitation Stroke 40

PulmCCM

SEPTEMBER 9, 2021

Septic sheep randomized to early, rapid volume resuscitation had greater vasopressor requirements 12 hours after initial fluid bolus. It is suggested that rapid, fluid resuscitation generates an abrupt rise in atrial natriuretic peptide, shears the glycocalyx which then impairs vascular reactivity. older than 65 years; b.]

Resuscitation 40

Resuscitation Fluid Resuscitation Sepsis Outcomes 40

Mind The Bleep

MAY 12, 2023

9 There is no role for Tranexamic acid in upper GI bleeding and its use is harmful to patients 11 Escalate to a senior early for consideration of a higher level of care Refer for early endoscopy after resuscitation with haemodynamic stability. On Day 3 (i.e. 48 hours later) albumin is administered at 1g/kg. On Day 3 (i.e.

Fluid Resuscitation 52

Fluid Resuscitation Dehydration Resuscitation Administration 52

Don't Forget the Bubbles

JUNE 10, 2024

Systemic Infections : Sepsis and other systemic infections can predispose infants to NEC by compromising the gut barrier and promoting inflammation. Differential diagnoses include septic ileus, and infection causes such as sepsis, meningitis and pneumonia. How do we diagnose necrotising enterocolitis?

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

In addition, the patient received 750 mL of fluid resuscitation with transient improvement of blood pressure. Author continued : STE in aVR is often due to left main coronary artery obstruction (OR 4.72), and is associated with in-hospital cardiovascular mortality (OR 5.58).

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

EB Medicine

NOVEMBER 1, 2018

It was peer reviewed by Dr. O’Keefe and Dr. Silverberg from Florida State University College of Medicine and Kings County Hospital, respectively. Jeff: And unlike past issues covering more common pathologies, like, say, sepsis, this month’s team reviewed much more literature than just the past 10 years. That’s -- high.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

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 93

EMDocs

OCTOBER 5, 2024

They are found primarily in hospital specimens but are increasing in frequency in samples from the community. 8 Workup and Diagnosis Evaluation should be tailored to the patient presentation, but may include studies such as: CBC, CMP, UA, lactate (if concern for sepsis), Cultures (blood, urine, etc.) IV fluid resuscitation as needed.

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EMS Infectious Diseases Sepsis Hospitals 98

EMDocs

JUNE 27, 2024

768: Epidemiology of Hospital Based ED Visits due to Sickle Cell Crisis and Acute Chest Syndrome in Kids. This series provides evidence-based updates to previous posts so you can stay current with what you need to know. 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

Pediatrics 98

Pediatrics Dehydration EMS Hospitals 98

PulmCCM

MAY 22, 2023

In the TEAM trial conducted by the ANZICS group, 750 ICU patients in 49 hospitals in 6 countries were randomized to either early mobilization or usual care (which usually included in-bed physical therapy). centers, patients with sepsis and systolic blood pressure <100 mm Hg all received at least 1000 mL of crystalloid.

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Fluid Resuscitation Resuscitation Hospitals Sepsis 86

EMDocs

JANUARY 20, 2025

Sepsis There has been much controversy over the last two decades around the various nuances of volume resuscitation in ED patients with suspected sepsis, much of which goes beyond the scope of this limited review. 9 In terms of assessing volume status in general, Joseph et al. 11 A study by Stephan et al. Andrews et al.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

Don't Forget the Bubbles

JULY 3, 2024

The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). Trends in C-Reactive Protein Use in Early-Onset Sepsis Evaluations and Associated Antibiotic Use. Can’t get enough of Bubble Wrap? Pediatrics.

Pediatrics 105

Pediatrics Fluid Resuscitation Research Hospitals 105

Don't Forget the Bubbles

NOVEMBER 18, 2024

Epidemiology in Australia In Australia, the reported prevalence of neonatal hypotension in preterm infants is like that in the UK, with around 20-30% of very low birth weight infants experiencing significant hypotension during their initial hospital stay. Effective management of MAS will often result in the stabilization of blood pressure.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

Don't Forget the Bubbles

FEBRUARY 17, 2025

He has received 20ml/kg in 5 to 10ml/kg aliquots in the ED, as his blood pressure keeps dropping, and the ED team is concerned about possible sepsis. He has been started on timely broad-spectrum antibiotics according to hospital protocol. Pudjiadi, Inferior Vena Cava/Abdominal Aorta Ratio as a Guide for Fluid Resuscitation.

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Pediatrics Ultrasounds Shock Resuscitation 78

Taming the SRU

FEBRUARY 3, 2025

Patients with TLS should be admitted to the hospital with concurrent management from the oncology and renal teams. Additional Treatments for Severe Electrolyte Derangements Severe Hyperuricemia If uric acid 8 mg/dL or 25% increase from baseline develops, then rasburicase should be administered in addition to IV fluid resuscitation.

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56