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emDOCs Podcast – Episode 115: Adult Meningitis

EMDocs

HSV meningitis needs hospital admission. The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults [published correction appears in J Infect. What about a CT before a Lumbar puncture? The benefits of giving acyclovir far outweigh any risks.

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The 79th Bubble Wrap x Bristol Royal Hospital For Children

Don't Forget the Bubbles

We have teamed up with the team from the Emergency Department at Bristol Royal Hospital, who have used this as a springboard for their journal club. (It’s The hospital is the Paediatric Major Trauma Centre for the South-West. Reviewed by: John Coveney Article 2: How do we define sepsis in children? doi:10.1001/jama.2024.0179

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2023 Critical Care Year in Review (Part 1)

PulmCCM

Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid bolus) led to similar outcomes as the usual practice of bolusing large volumes of fluids first. Either approach in severe sepsis with shock seems reasonable.

Sepsis 94
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Professional Medical Societies Call for Elimination of SEP-1

PulmCCM

The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1). The stakes are going up.

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The Latest in Critical Care, 2/5/24 (Issue #28)

PulmCCM

Fever in the ICU: Guideline Update The Society of Critical Care Medicine (SCCM) and the Infectious Diseases Society of America (IDSA) issued an interim update to their 2008 recommendations for the management of fever in the ICU. PulmCCM is not affiliated with SCCM or IDSA. You can read the document here. What’s a Fever?

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Medical Malpractice Insights: A Rare Presentation – Groin pain? Nec fasc? Diabetes? Appendicitis?

EMDocs

Hospital Inpatient : R thigh is indurated and blistered but abdomen is all but ignored. On the 2nd hospital day, she becomes obtunded and is intubated. Sepsis is diagnosed and antibiotics started for the first time. She only gets worse, and by the 4th hospital day she is unresponsive. She admitted to the ICU for “DKA.”

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Diagnostics: Inflammatory Markers

Taming the SRU

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear.