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

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. Gut feelings: the intelligence of the unconscious.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

EMDocs

JULY 13, 2024

Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis. Incidence, treatment and outcome of peripartum sepsis. Plasma cell endometritis is associated with Chlamydia trachomatis infection. Am J Clin Pathol.

OB/GYN 63

OB/GYN EMS Sepsis Fluid Resuscitation 63

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

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

PulmCCM

MAY 22, 2023

Early mobilizers got significantly more exercise, but had no improvement in any clinical outcome (days alive outside the hospital, ventilator-free days, ICU-free days, or cognitive or psychological function). centers, patients with sepsis and systolic blood pressure <100 mm Hg all received at least 1000 mL of crystalloid.

Fluid Resuscitation 86

Fluid Resuscitation Resuscitation Hospitals Sepsis 86

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. vs. 0.91), positive predictive value (0.27

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Sepsis Fluid Resuscitation Resuscitation Shock 65

Northwestern EM Blog

FEBRUARY 14, 2022

The primary outcome of the study was the response in MAP three hours after the start of angiotensin II infusion. It showed improvement in blood pressure which is a clinically important parameter but not a patient-oriented outcome. However, one limitation of the study was that it was underpowered to demonstrate a mortality difference.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

EMDocs

JUNE 27, 2024

Intravenous fluid therapy and hospital outcomes for vaso-occlusive episodes in children, adolescents, and young adults with sickle cell disease. Factors associated with adverse outcome among children with sickle cell disease admitted to the pediatric intensive care unit: an observational cohort. C or 100.4 mg/kg, max 0.4

Pediatrics 75

Pediatrics Dehydration EMS Hospitals 75

Don't Forget the Bubbles

JUNE 10, 2024

Despite advancements in neonatal care, NEC remains a significant concern due to its association with adverse outcomes, including prolonged hospitalisation, the need for surgical intervention, and increased mortality rates. Differential diagnoses include septic ileus, and infection causes such as sepsis, meningitis and pneumonia.

Pediatrics 40

Pediatrics Sepsis Fluid Resuscitation Outcomes 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

Taming the SRU

AUGUST 25, 2023

bicarb <18mEq/L) ketosis (preferably serum beta-hydroxybutyrate >3mmol/L) Risk factors SGLT2 inhibitor use fasting state ketogenic diet intra-abdominal pathology (AGE, pancreatitis, etc.) to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2

Seizures 74

Seizures Fractures EKG/ECG Resuscitation 74

EMDocs

OCTOBER 5, 2024

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. 12 Complications Inadequate empiric therapy can lead to treatment delays and worse outcomes.

EMS 73

EMS Infectious Diseases Sepsis Hospitals 73

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. saline + 5% dextrose or plasma-lyte 148 + 5% dextrose. Boluses were given in 20-40ml/kg aliquots.

Fluid Resuscitation 96

Fluid Resuscitation Hospitals Dehydration Research 96