Taming the SRU

AUGUST 30, 2023

Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear. A 2013 meta-analysis of 30 studies including 3,244 patients published in The Lancet found PCT to have a pooled sensitivity of 77% and specificity of 79% for sepsis in critically ill patients [52]. Cleland DA, Eranki AP.

Infectious Diseases 89

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 89

ACEP Now

OCTOBER 30, 2023

Oftentimes, it can be an indication of pain, infection, distress, anxiety, dehydration, or the first sign of sepsis.

Sexual Assault 98

Sexual Assault Teamwork Dehydration Outcomes 98

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47

Stroke 133

Stroke Outcomes Hospitals Administration 133

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.

EKG/ECG 52

EKG/ECG Sepsis Documentation/Coding Stroke 52

Broome Docs

APRIL 6, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. Immobilisation of torus fractures of the wrist in children (FORCE): a randomised controlled equivalence trial in the UK. N Engl J Med. 2023 Jan 21. doi: 10.1056/NEJMoa2212663. Epub ahead of print. PMID: 36688507 You can read Justin’s Full write up here.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Pediatric Emergency Playbook

JULY 1, 2016

T – Toddler’s fracture This is usually a torque injury when the wobbling toddler pivots quickly or trips and falls. Toddler’s fractures happen in children 1 to 3 years of age, and occur in the distal 1/3 of the tibia. Sometimes a cast is needed, but currently there is a new trend in foregoing casting in mild cases.

Fractures 52

Fractures Poisoning Wellness Sepsis 52

The Skeptics' Guide to EM

APRIL 20, 2019

This have included the following medical myths: * Myth: Epinephrine saves lives with good neurologic outcome in OHCA ( SGEM#64 and SGEM#238 ) * Myth: All buckle and greenstick fractures should be casted ( SGEM#19 ) * Myth: A vitamin C cocktail can cure sepsis based on an observational study ( SGEM#173 ) * Myth: Ketorolac 30mg IV is better than 10mg (..)

Emergency Nursing 40

Emergency Nursing Sepsis EMS Fractures 40

Northwestern EM Blog

APRIL 25, 2022

Violation of the joint capsule exposes the sterile intra-articular space to the environment which can result in a deep infection and sepsis. X - ray : Many times, next step will be to get an X-ray to look for associated fractures. It provides additional information about any associated fractures. CT is painless.

Soft Tissue Injuries 52

Soft Tissue Injuries Fractures Sepsis Documentation/Coding 52

RebelEM

MARCH 9, 2023

Pain / Additional Complaints : Alcohol can weaken the immune system with only moderate use, predisposing individuals to pneumonia, soft tissue infections, and sepsis. Assess for blood in the nares or signs of basal skull fracture, including battle signs, raccoon eyes, or hemotympanum. Remove all clothing and do a full skin exam.

Psychiatric 52

Psychiatric Emergency Department Fractures Documentation/Coding 52

ACEP Now

MAY 9, 2024

Classically associated with long bone fractures, a PFE may also occur when fat is injected or absorbed into a blood vessel during the reinjection phase of an AFT procedure. Other complications seen in our cohort included sepsis, hemorrhagic shock, electrolyte derangements, bowel perforation, hematomas, abscess formation, and cardiac arrest.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

PulmCCM

FEBRUARY 12, 2024

Severity of pneumonia was not formally defined in the recommendation, owing to the heterogeneity of analyzed trials, but mechanical ventilation, severe sepsis, high pneumonia severity scores, ICU admission, or need for vasopressors were some heuristics used.

Shock 52

Shock Administration Sepsis Fractures 52

EB Medicine

NOVEMBER 1, 2018

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. Cerebral salt wasting syndrome, peripheral nerve lesions, spinal cord fracture, and cerebral hemorrhages have all been described.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

EB Medicine

JUNE 6, 2019

Nachi: And as a brief aside, before we continue… Missed appendicitis is one of the three most common causes of emergency medicine malpractice lawsuits - with MI and fractures being the other two. However, it can also be due to hypoxia, sepsis, anemia, PE, or metabolic acidosis, so consider all of those also in your differential.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

First 10 EM

APRIL 10, 2023

Before jumping into this edition, I need to address the maternal kisses study discussed last time. Obviously the study was satire, and did an excellent job in making us laugh, but most satire studies (like those in the Christmas edition of the BMJ) are real studies.

Research 52

Research Sepsis Fractures EMS 52

Don't Forget the Bubbles

MARCH 4, 2024

Reviewed by: John Coveney Article 2: How do we define sepsis in children? International Consensus Criteria for Pediatric Sepsis and Septic Shock. The aim of this paper was to update and evaluate the criteria for sepsis and septic shock in children. It doesn’t help to diagnose or exclude sepsis. doi:10.1001/jama.2024.0179

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

Emergency Medicine Cases

JUNE 13, 2017

The post Episode 97 EM Literature Review 2016 from EMU & Whistler Conferences appeared first on Emergency Medicine Cases.

EMS 52

EMS Head Injuries Pediatrics Sepsis 52

Don't Forget the Bubbles

JULY 22, 2024

There is an increased risk of pneumonia and sepsis in the 31-90 days after prescription and an increased risk of fractures, GI bleeds and sub-optimal growth. Whilst the incidence of adverse events was low in this meta-analysis, this reflects adverse event reporting in RCTs rather than reality.

Outcomes 105

Outcomes Research Pediatrics Hospitals 105

Don't Forget the Bubbles

MAY 8, 2024

2024 Apr 3:114037 Apnea, Intermittent Hypoxemia, and Bradycardia Events Predict Late-Onset Sepsis in Infants Born Extremely Preterm. Hemotympanum with a Basilar Skull Fracture. Cerebral Palsy and Motor Impairment after Extreme Prematurity: Prediction of Diagnoses at Ages 2 and 10 Years. Marinelli T, et al. Kausch SL, et al.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane).

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

Don't Forget the Bubbles

JULY 17, 2023

Original clinical studies Distribution and pattern of hand fractures in children and adolescents. Evaluating the Impact of the 2017 Dutch Neonatal Early-Onset Sepsis Guideline. Ultrasonography or Radiography for Suspected Pediatric Distal Forearm Fractures. JAMA Pediatr. 2023 Jun 1;177(6):559-560. Arneitz C, et al. N Engl J Med.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

RCEM Learning

NOVEMBER 28, 2022

Introduction Immediate management Control of haemorrhage Use of pelvic binder REBOA Management of stable VS unstable fracture Management of closed VS open fracture Other injuries Immediate management Coordinated and structured approach (eg. Learning bite Nearly 90% of pelvic fracture bleeding is venous in origin.

Fractures 40

Fractures Blood Transfusions Sepsis Operations 40

Taming the SRU

AUGUST 25, 2023

doxycycline Consider a splint/cast window to allow direct monitoring mainly used for fracture blisters and/or open wounds yet takes away from the strength of the splint/cast Case #3 43yo with FOOSH injury and closed wrist deformity, yet no x-ray machine is available to you Least likely injuries to need an x-ray in a resource-limiting setting?

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75

Don't Forget the Bubbles

NOVEMBER 6, 2024

Update to the Neonatal Early-Onset Sepsis Calculator Utilizing a Contemporary Cohort. Palpable signs of skull fractures on physical examination and depressed skull fractures or traumatic brain injuries on CT in children. Trends in C-Reactive Protein Use in Early-onset Sepsis Evaluations and Associated Antibiotic Use.

Pediatrics 52

Pediatrics Sepsis Fractures Hospitals 52

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Don't Forget the Bubbles

SEPTEMBER 23, 2024

Kidney transplant recipients have a higher risk of fractures. Consider sepsis and treat it accordingly. Kidney transplant recipients are at higher risk of rickets and fractures. (13) Ask about the frequency of intermittent catheterization, if applicable. Any history of injury? CAKUT, catheterization requirement).

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Mind The Bleep

SEPTEMBER 17, 2024

Feel: Palpate the area of the bite to feel for areas of tenderness as this could indicate a fracture or infection. There should be a minimum of 2 views in the plain film, or 3 in the hands if there is a suspicion of a fracture. Always consider management as per ATLS protocol and SEPSIS 6 if relevant. Regular medications.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

Don't Forget the Bubbles

NOVEMBER 6, 2024

Update to the Neonatal Early-Onset Sepsis Calculator Utilizing a Contemporary Cohort. Palpable signs of skull fractures on physical examination and depressed skull fractures or traumatic brain injuries on CT in children. Trends in C-Reactive Protein Use in Early-onset Sepsis Evaluations and Associated Antibiotic Use.

Pediatrics 59

Pediatrics Sepsis Fractures Hospitals 59

Mind The Bleep

NOVEMBER 2, 2024

If you are concerned that the clavicle may be fractured then arrange an x-ray and discuss the findings with the orthopaedics team. Swab any discharge and discuss with a senior about starting antibiotics as infection in a baby can quickly lead to sepsis. Undo the nappy of the baby and palpate the Femoral pulses.

Dislocations 52

Dislocations Documentation/Coding Ultrasounds Wellness 52