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.

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

MARCH 4, 2024

12 Ultrasound and computed tomography (CT) can both identify CBD and are available in most emergency departments. Ultrasound is cost-effective and radiation-sparing. Ultrasound has approximately 90% sensitivity for detecting common bile duct dilation. 13 CT is also superior to ultrasound in its ability to detect malignancy.

Emergency Department 105

Emergency Department Ultrasounds EMS Radiology 105

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.

OB/GYN 89

OB/GYN EMS Sepsis Fluid Resuscitation 89

Don't Forget the Bubbles

MAY 17, 2023

The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. Original clinical studies The impact of the early onset neonatal sepsis calculator on antibiotic initiation: a single center study in Israel. Levi M, et al.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Taming the SRU

FEBRUARY 5, 2024

It is most helpful to do the ultrasound immediately before needle insertion, as movement of the patient may shift cutaneous landmarks from underlying bony structures. This resource offers additional information on ultrasound assisted LP’s. 2018) Epidemiology of lumbar punctures in hospitalized patients in the United States.

Infectious Diseases 97

Infectious Diseases Seizures Ultrasounds Sepsis 97

EMDocs

JULY 29, 2023

Transoral Ultrasound in the Diagnosis of Obstructive Salivary Gland Pathologies. Ultrasound Med Biol. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Rev Infect Dis.

EMS 96

EMS Dehydration Ultrasounds Emergency Department 96

Northwestern EM Blog

MAY 16, 2022

What is your initial imaging test of choice, ultrasound (US) or non-contrast CT, and why? Would you be confident in a point-of-care-ultrasound evaluation or a formal ultrasound? were hospitalizations during f/u period; 26.4% were hospitalizations during f/u period; 26.4% were hospitalizations during f/u period; 26.4%

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

The Skeptics' Guide to EM

OCTOBER 23, 2021

Pathway with single-dose long-acting intravenous antibiotic reduces emergency department hospitalizations of patients with skin infections. Pathway with single-dose long-acting intravenous antibiotic reduces emergency department hospitalizations of patients with skin infections. Date: October 20th, 2021 Reference: Talan et al.

Emergency Department 52

Emergency Department Sepsis Hospitals Research 52

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]. Instead, they strongly advocated for the use of lung ultrasound to diagnose bacterial CAP [45]. days (secondary endpoint) [51].

Infectious Diseases 89

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

ACEP Now

MAY 4, 2023

Diagnosis: Complex Hydrocele (Pyocele) The testicular ultrasound revealed a small left complex hydrocele suspicious for pyocele. Early treatment with broad-spectrum antibiotics is essential to prevent sepsis and preserve testicular function. Dr. Rader works at Ascension Macomb-Oakland Hospital. Click to enlarge.) 2012;5(2):206.

Urgent Care 52

Urgent Care Ultrasounds Sepsis Emergency Department 52

Dr. Smith's ECG Blog

JULY 21, 2024

The patient was extubated on Day-3 of the hospital stay. The stay in the cardiac intensive care unit (CICU) was further complicated by sepsis, delirium, GI bleeding, and anuric renal failure with need for renal replacement therapy. However, he suddenly developed a series of malignant ventricular arrhythmias.

EKG/ECG 131

EKG/ECG Shock Hospitals Sepsis 131

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. 2018, Kuttab, Lykins et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Emergency Medicine Journal

JULY 24, 2023

A newspaper on my neighbour’s stoop declares a Historic Drought in New England, but in my hospital’s basement, water leaks from the ceiling. An intern says he wants to complete sepsis bundles; a second-year is shooting for more bedside ultrasounds. Beyond them, in the collective treatment area, is a flood.

Sepsis 40

Sepsis Ultrasounds Hospitals 40

ACEP Now

MAY 9, 2024

6 The increasing mortality rate led to an additional emergency regulation in 2022 requiring the consenting physician to perform the critical steps of the case, limiting surgeons to three cases per day, and mandating continuous, recorded ultrasound guidance for gluteal AFT procedures. References Garcia SE. Butt Lifts Are Booming.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

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

Broome Docs

APRIL 6, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. Clinical risk factors for testicular torsion and a warning against falsely reassuring ultrasound scans: a 10-year single-centre experience. Clinical Outcomes After Intensifying Antihypertensive Medication Regimens Among Older Adults at Hospital Discharge.

Sepsis 52

Sepsis Ultrasounds Hospitals Fractures 52

Pediatric Emergency Playbook

AUGUST 1, 2017

Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. J Ultrasound. Management of the child after enema-reduced intussusception: hospital or home? The non-diagnostic ultrasound in appendicitis: is a non-visualized appendix the same as a negative study? Ultrasound Evaluation for Appendicitis.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

University of Maryland CC Project

OCTOBER 5, 2021

Mallia, Assistant Professor of Emergency Medicine and Associate Program Director of the Pulmonary and Emergency Medicine-Critical Care Fellowship at MedStar Washington Hospital presents on critical care ultrasound for the assessment of the LV and RV as part of the DC5 lecture series. Dr. Anantha K.

Ultrasounds 40

Ultrasounds Hospitals Sepsis 40

Don't Forget the Bubbles

MAY 8, 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). Use of neonatal lung ultrasound in European neonatal units: a survey by the European Society of Paediatric Research. Shah M, et al. Brooks L, et al.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

The Skeptics' Guide to EM

JANUARY 25, 2020

His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Case: A 60-year-old male is in your emergency department with sepsis from pneumonia.

EMS 40

EMS Airway Management Administration Resuscitation 40

Pediatric Emergency Playbook

JUNE 1, 2016

Cardiogenic Shock: Act Use point-of-care cardiac ultrasound : Good Squeeze? It’s seen easily enough on point of care ultrasound. Tamponade: if any sign of shock, pericardiocentesis, preferentially ultrasound-guided. Children with sepsis come in two varieties: warm shock and cold shock. Pericardial Effusion? Pediatrics.

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

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. But what does that mean to us clinically in the ED and ICU?

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

Emergency Medicine Ireland

DECEMBER 24, 2020

The pathophys is challenging to study but one animal model we do have suggested renal blood flow actually increases initially with the hyperdynamic state of sepsis without histological signs of injury. Excluding obstruction in AKI with some imaging like an ultrasound is a common recommendation but incredibly low yield.

Sepsis 40

Sepsis Ultrasounds EMS Hospitals 40

EB Medicine

JUNE 6, 2019

Taylor and Shaukat of Emory and Coney Island Hospital respectively for their efforts in peer reviewing this huge topic. CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Jeff: Indeed. Sounds familiar. Jeff: We sure did!

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

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. Ask your renal team if the hospital has a subscription. This list is not exhaustive, and, as always, if you are unsure about anything, you should always escalate.

Fluid Resuscitation 52

Fluid Resuscitation Hospitals Sepsis EKG/ECG 52

Taming the SRU

MAY 1, 2023

Trauma/Pre-Hosp Optimal Out-of-Hospital Blood Pressure in Major Traumatic Brain Injury: A Challenge to the Current Understanding of Hypotension Link: [link] Bottom Line: Think about maintaining normotension rather than simply avoiding hypotension in isolated TBI. and NPV(50%).

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

Don't Forget the Bubbles

MAY 28, 2024

Hence, PPHN can be idiopathic or secondary to a variety of conditions such as meconium aspiration syndrome , respiratory distress syndrome, sepsis, asphyxia and congenital diaphragmatic hernia. Were there any abnormalities on ultrasounds? Great Ormond Street Hospital. Imagine being a few hours old and dealing with this).

Sepsis 52

Sepsis Ultrasounds Pediatrics Research 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

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

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

However, STE-aVR with multilead ST depression was associated with 31% in-hospital mortality compared with only 6.2% Widespread ST-depression with reciprocal aVR ST-elevation can be cause by: Heart rate related: tachyarrhythmia (e.g., A total of 47 patients (59%) were found to have severe coronary disease , but most had intact distal flow.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 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 91

Sepsis Fluid Resuscitation Resuscitation Shock 91

EB Medicine

SEPTEMBER 1, 2018

Nachi: Right, but in Australia, not only are the snakes more venomous but the hospital transport distances are much longer, so, basically they sacrifice the limb to potentially save a life. Jeff: I feel like we should get some entry music for every ultrasound reference because it seems to make its way into just about every episode.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

Don't Forget the Bubbles

NOVEMBER 1, 2023

This month, Bubble Wrap has teamed up with Sheffield Children’s Hospital Emergency Department to have a look at what’s new in paediatric literature. Sheffield Children’s Hospital is a stand-alone tertiary children’s hospital in the heart of Sheffield with a paediatric MTC. mmol/L with the median of 2.6

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

EMDocs

OCTOBER 23, 2023

Operative complications requiring surgical intervention or hospitalization occur in about 3-6% of all hysterectomies (5). Diagnosis can be confirmed with ultrasound (for deep vein thrombosis) or CT angiography (CTA) chest (for pulmonary embolism) and patients treated with anticoagulants.

OB/GYN 93

OB/GYN Operations EMS Ultrasounds 93

Don't Forget the Bubbles

JULY 17, 2023

The Bubble Wrap Plus is a monthly paediatric journal club reading list from Anke Raaijmakers, working with Professor Jaan Toelen and his team at the University Hospitals in Leuven. Reviews and opinion articles Point-of-care ultrasound in pediatric nephrology. Can’t get enough of Bubble Wrap? Sethi SK, et al. Pediatr Nephrol.

Pediatrics 98

Pediatrics Emergency Department Outcomes Fractures 98

Don't Forget the Bubbles

FEBRUARY 5, 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). Role of diagnostic tests for sepsis in children: a review. Risk Factors for Severe Respiratory Syncytial Virus Infection in Hospitalized Children.

Pediatrics 52

Pediatrics Research Resuscitation Psychiatric 52

PEMBlog

JANUARY 17, 2024

Full blown sepsis and toxic shock syndrome. If you think that there’s an abscess, you can diagnose it clinically by a localized area of induration or fluctuance or use an ultrasound. So when do you want to think about admission to the hospital or short stay unit versus discharge? Bilateral red limbs?

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59