PEMBlog

JANUARY 17, 2024

Camargo, Clinical Trial: Comparative Effectiveness of Cephalexin Plus Trimethoprim-Sulfamethoxazole Versus Cephalexin Alone for Treatment of Uncomplicated Cellulitis: A Randomized Controlled Trial, Clinical Infectious Diseases, Volume 56, Issue 12, 15 June 2013, Pages 1754–1762, [link] Liu C, Bayer A, Cosgrove SE, et al.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

PulmCCM

JULY 10, 2023

Continuous meropenem infusion for critically ill patients with sepsis Antibiotics have a time-dependent effect on bacteria; maintaining bacteriocidal concentrations of antibiotics should help subdue infections better than intermittent dosing. Mortality was about 30% in each group, and most patients had hospital-acquired sepsis.

Stroke 52

Stroke Sepsis Infectious Diseases Outcomes 52

Don't Forget the Bubbles

JANUARY 10, 2024

Severe anaemia is a common and life-threatening cause of hospital admission in children in sub-Saharan Africa. 8% die in hospital, with a further 12% dying in the six months following discharge. Population 6171 children from three hospitals in Uganda and one in Malawi were assessed for eligibility. Do you believe the results?

Blood Transfusions 78

Blood Transfusions Research Outcomes Hospitals 78

PulmCCM

JUNE 19, 2023

No drug or combination improved the primary outcome (a composite outcome of hypoxemia, visit to the emergency department, hospitalization, or death). Read in Lancet Infectious Diseases Severe hypothyroidism, although rare, may be under-recognized in the ICU and lead to worse outcomes during critical illness, authors of a case series argue.

Infectious Diseases 52

Infectious Diseases Hyperthermia / Hypothermia Outcomes Sepsis 52

ACEP Now

MARCH 6, 2024

Finally, the “EXACT” trial examined whether, in patients with return of spontaneous circulation after an out of hospital cardiac arrest, a peripheral oxygenation target of 90–94 percent conferred a survival benefit, as compared with the typical 98–100 percent. Survival to hospital discharge favored the “standard care” group, 47.9

Research 52

Research Airway Management Stroke Outcomes 52

Northwestern EM Blog

JUNE 16, 2024

Myocardial Infarction Medication Sinus node dysfunction Infectious Disease Hypothermia Metabolic Abnormalities (hypothyroidism, hyperkalemia, ect.) For example, hypothyroidism, adrenal insufficiency, sepsis, neuromuscular disease, malnutrition, thiamine deficiency, hypoglycemia can all lead to hypothermia [11-13].

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Infectious Diseases Stroke Poisoning 52

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.

Sepsis 75

Sepsis Fluid Resuscitation Resuscitation Shock 75

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.)

EMS 86

EMS Infectious Diseases Sepsis Hospitals 86

PEMBlog

OCTOBER 18, 2023

rectally, prompting a sepsis workup given his age. This patient was hospitalized for 4 days where he remained well-appearing. The patient was ultimately discharged on a seven-day total course of cephalexin per Pediatric Infectious Disease recommendations. His rash is pictured here: He subsequently developed a fever to 38.2C

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

Taming the SRU

AUGUST 30, 2023

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.

Infectious Diseases 88

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 88

EMDocs

OCTOBER 10, 2024

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.”

Documentation/Coding 87

Documentation/Coding Hospitals Sepsis Infectious Diseases 87

Mind The Bleep

SEPTEMBER 17, 2024

Epidemiology The number of animal bites presented to A&E is largely underestimated, as many who are bit don’t present to receive medical care 1 or won’t receive treatment in a hospital setting so they are not counted in the statistics for bites 2. Always consider management as per ATLS protocol and SEPSIS 6 if relevant.

Fractures 52

Fractures Infectious Diseases Documentation/Coding Hospitals 52

Pediatric Education

AUGUST 20, 2023

per 100,000 hospitalizations in 2014. ” In the Belgium study, the most common underlying risk factor was hepatobiliary disease (e.g. Treatment duration again was lengthy for many (up to 154 days) and they had a survival rate of 95.8%. Mortality rate was 0.8%. .” Questions for Further Discussion 1.

Pediatrics 40

Pediatrics Infectious Diseases Wellness Sepsis 40

ACEP Now

MAY 4, 2023

Early treatment with broad-spectrum antibiotics is essential to prevent sepsis and preserve testicular function. Dr. Rader works at Ascension Macomb-Oakland Hospital. Dr. Fishman is an associate program director at Ascension Macomb-Oakland Hospital. Fishman is an associate program director at Ascension Macomb-Oakland Hospital.

Urgent Care 52

Urgent Care Ultrasounds Sepsis Emergency Department 52

Don't Forget the Bubbles

MARCH 4, 2024

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

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

Don't Forget the Bubbles

SEPTEMBER 18, 2023

This is true in life-threatening conditions such as sepsis. However, when children do not have features of sepsis, oral antibiotics are equally effective. The take home is that although IV antibiotics are key in sepsis management, oral antibiotics are equally as effective as IV antibiotics for children without critical illness.

Emergency Department 143

Emergency Department Infectious Diseases Pediatrics Sepsis 143

RebelEM

MAY 15, 2024

Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. Follow your hospital’s protocol (if available). High Risk Patients will need hospitalization and IV antibiotics. Improving the immediate management of neutropenic sepsis in the UK: Lessons from a national audit. Clarke, R.

Infectious Diseases 86

Infectious Diseases Administration Sepsis Anaphylaxis 86

Don't Forget the Bubbles

SEPTEMBER 23, 2024

You are working in the paediatric emergency department of a busy District General Hospital. Infections are the most common reason for hospitalization within the first two years of transplant and are much more likely than rejection. Have there been any previous episodes of hospitalization since receiving the transplant?

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Mind The Bleep

NOVEMBER 20, 2024

Infectious disease (ID) is much more than simply collecting blood cultures; it’s a dynamic and exciting specialty that offers the opportunity to work with patients of all ages, varying acuities, and diverse clinical presentations. Contents What makes ID a great career choice? What makes ID a great career choice?

Infectious Diseases 52

Infectious Diseases Research Patient Safety Sepsis 52

ACEP Now

NOVEMBER 7, 2024

If you work in the emergency department, you’re out there in the trenches “suspecting sepsis” on a daily basis. These are among the questions at the forefront in the exciting world of infectious disease. Considering the wide usage of these antibiotics in the current approach to sepsis, an urgent answer ought be sought.

Sepsis 64

Sepsis Infectious Diseases Outcomes Emergency Department 64

EMDocs

DECEMBER 9, 2024

Patients who do not require hospitalization can be discharged with instructions to strictly quarantine from others, including mammals (dogs, cats, etc.), as these animals can contribute to the spread of disease. Special populations that might be considered for treatment include: Patients with severe disease (e.g.,

CDC 68

CDC Documentation/Coding Infectious Diseases Dehydration 68

EMDocs

FEBRUARY 8, 2025

On chart review, a sputum culture collected during a recent hospital visit grew a species of Aspergillus. Empiric treatment with voriconazole 6 mg/kg twice daily intravenously for 2 doses should be started immediately based on Infectious Disease Society of America (IDSA) guidelines. mortality: 42-63% 5 Invasive Candida spp.

Infectious Diseases 61

Infectious Diseases EMS COPD Research 61