RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below). to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 133

Stroke Outcomes Hospitals Administration 133

Dr. Smith's ECG Blog

APRIL 2, 2024

He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. Then the patient's electronic record from an outside hospital appeared. Patient received 11 shocks by ICD and was in V-fib when EMS arrived. Here is the initial ED ECG. What do you think?

EKG/ECG 134

EKG/ECG Shock CPR Stroke 134

Pediatric Emergency Playbook

JUNE 1, 2016

Do we recognize shock early enough? World wide, shock is a leading cause of morbidity and mortality in children, mostly for failure to recognize or to treat adequately. So, what is shock? Simply put, shock is the inadequate delivery of oxygen to your tissues. How do we prioritize our interventions? Pericardial Effusion?

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Taming the SRU

JUNE 3, 2024

Susan Wilcox Increasing regionalization due to: Growth of specialty centers Increasing development of healthcare systems Hub-and-spoke models Development of ECMO, trauma, transplant, and stroke centers The higher the acuity of the centers, the higher the acuity of the patient that needs to get there. What drives the concern?

Shock 91

Shock Seizures Airway Management Stroke 91

Don't Forget the Bubbles

FEBRUARY 5, 2025

All hospitals will have different makeups of trauma teams and possibly different levels of activation) Do I need any additional expertise outside of who would typically be in the trauma team? Disability – Altered mentation, seizure, stroke symptoms, severe headache, neurological deficit, visual symptoms.

Domestic Violence 59

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 59

University of Maryland CC Project

JUNE 16, 2023

The first annual Mid-Atlantic Neurocritical Care Symposium will bring together experts from The University of Maryland/Shock Trauma Hospital, Johns Hopkins University, INOVA, Christiana Care, and beyond to discuss the basics of caring for critically ill neurological patients, as well as highlight recent innovations in the field.

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Shock Hospitals Wellness Stroke 70

Taming the SRU

APRIL 17, 2024

Results They studied 1852 patients in the MICU with the most common admission diagnoses being respiratory failure (34 %), sepsis (23 %), and primary CNS disease such as stroke or hemorrhage (23 %). Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med. 2021;49:e1063-e1143.

Sepsis 94

Sepsis Research Stroke Academics 94

RebelEM

JUNE 8, 2023

They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine. The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. Intensive Care Med. 2018;44(6):857–67. 2006;130(4):941–6.

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

PulmCCM

JULY 10, 2023

In the MERCY trial, 607 critically ill patients with sepsis (most with septic shock) at 26 hospitals in Croatia, Italy, Kazakhstan, and Russia were randomized to receive meropenem by either continuous (3 g / 24 hours) or intermittent administration (1 g every 8 hours). However, the practice has not been supported by randomized trials.

Stroke 52

Stroke Sepsis Infectious Diseases Outcomes 52

Ziqitza HealthCare Ltd

JUNE 13, 2024

Difficulty speaking Sudden speech difficulties, weakness, or numbness could be an emergency medical warning sign of a stroke. Major issues like stroke, internal bleeding, low blood sugar levels, and sudden drops in blood pressure could all accompany this warning sign. These also require emergency medical intervention at the earliest.

Burns 52

Burns Stroke Ambulance Services Seizures 52

Dr. Smith's ECG Blog

JANUARY 9, 2024

Slow VT below the detection rate of the ICD lead to worsening heart failure and low stroke volume. Lowering the back up rate (LRL) of the ICD/pacer allowed for an intrinsic rhythm with physiologic AV conduction and normal AV synchrony with resultant increase in stroke volume and cardiac outpt.

EKG/ECG 120

EKG/ECG Stroke Hospitals Documentation/Coding 120

AED Leader

DECEMBER 6, 2024

Having accessible tools like external defibrillators in hospital settings is essential. Comprehensive Care : From basic life support to hospital cardiac care, a seamless approach is necessary. This collaboration focuses on improving cardiac arrest care in a hospital setting.

Basic Life Support 52

Basic Life Support Resuscitation Outcomes Hospitals 52

JournalFeed

MARCH 26, 2022

Epi vs. NorEpi Spoon feed: Continuous epinephrine infusion for post-resuscitation shock in out of hospital cardiac arrest (OHCA) was associated with both higher all-cause and cardiovascular specific mortality when compared to norepinephrine. Check out journalfeed.org for details.

Stroke 40

Stroke Documentation/Coding Emergency Department Shock 40

EB Medicine

JANUARY 10, 2020

MACE= Major Adverse Cardiovascular Event: including re-infarction, stroke, dysrhythmia, heart failure, cardiogenic shock, and death. In-hospital mortality rates are about the same for STEMI and NSTEMI, about 10%. Part 4: Pre-hospital care Prehospital ECGs decrease time to intervention. Part 2 : Why do we care?

Emergency Department 40

Emergency Department Shock EKG/ECG Sepsis 40

ACEP Now

MAY 9, 2024

Complications of Gluteal AFT The pale, prone patient with multiple surgical drains and a constrictive faja has become a common site in the Jackson Memorial Hospital Emergency Department. This should be suspected in patients with intraoperative cardiac arrest or shock. References Garcia SE. Butt Lifts Are Booming.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

Downeast Emergency Medicine

APRIL 26, 2021

Four level-1 US trauma centers participated in the study where the inclusion criteria were trauma patients who were within 2 hours of their injury and were transported to the trauma center from either the field or another hospital. MI or stroke). When looking at the subgroups with severe shock, there was an 18.5%

Head Injuries 52

Head Injuries Administration Outcomes Seizures 52

Stop and Think

MARCH 28, 2023

In the course of investigating this benign condition, the patient suffers a stroke from a coronary angiogram. Had this person never seen a doctor, or had no prevention efforts, she would have avoided a stroke. A person comes in for a yearly physical exam and is found to have an asymptomatic irregular heartbeat.

Stroke 52

Stroke Wellness Shock Hospitals 52

PulmCCM

DECEMBER 11, 2024

An excellent review article titled “Sepsis and Septic Shock” was published 4 December 2024 in the New England Journal of Medicine. It’s a wonderful contribution to the literature and well worth reading. But it feels like something important was missed, or misplaced.

Sepsis 45

Sepsis Shock Research Wellness 45

Pediatric Emergency Playbook

APRIL 1, 2016

Less common causes of troponemia are: Kawasaki disease, pediatric stroke, or neuromuscular disease. There are two main reasons for an elevated lactate: the stress state and the shock state. The shock state is due to tissue hypoxia, seen in septic shock. We should use lactate to detect occult shock.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Dr. Smith's ECG Blog

OCTOBER 7, 2019

When the physicians approached him, he was ashen, diaphoretic, and appeared in shock. Why is the patient in shock? He was in profound cardiogenic shock. Although the shock is no doubt partly a result of poor pump function, with low stroke volume, especially of the RV, it should be compensated for by tachycardia.

Seizures 40

Seizures EKG/ECG Shock EMS 40

ACEP Now

SEPTEMBER 13, 2023

Years before, he’d started his EM career as medical director of the ER at Memphis’ public hospital and Memphis Fire EMS. Kellermann was a member of the original committee and played a behind-the-scenes role in encouraging its formation. Accidental Death and Disability: The Neglected Disease of Modern Society. National Academics.

EMS 45

EMS Research Military Academics 45

Taming the SRU

MAY 3, 2023

CLINICAL CASE: History of Present Illness: An elderly female initially presented to an outside hospital with a variety of respiratory symptoms and was subsequently diagnosed with COVID-19 pneumonia. For a complete discussion of cardiogenic shock and right ventricular failure, please see this other Air Care Series post on the subject.

Wellness 52

Wellness Hospitals Shock Outcomes 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

EB Medicine

AUGUST 6, 2019

Nachi: Specifically, we’ll be focusing on the use of DOACs for the indications of stroke prevention in atrial fibrillation and the treatment and prevention of recurrent venous thromboembolisms. Jeff: Rivaroxaban, trade name Xarelto, the second FDA approved DOAC, is used for stroke prevention in those with nonvalvular afib and VTE treatment.

Emergency Department 40

Emergency Department Stroke Wellness Administration 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. Nachi: Each year, in the US, approximately 10,000 patients present with electrical burns or shocks. Schieche from the Oklahoma University School of Community Medicine. That’s -- high.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

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]. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. days (secondary endpoint) [51].

Infectious Diseases 89

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

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. In severe cases this can lead to systemic bleeding and even hemorrhagic shock. Nachi: Let’s move on to diagnostic studies.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

EB Medicine

MAY 3, 2019

Jeff: And while it seems crass to even mention the financial impact, the number is shocking - suicide has an estimated economic burden of $5.4 It’s also important to elicit any psychiatric history, including prior hospitalizations. These patients typically do not require inpatient hospitalization. billion per year in the US.

Emergency Department 40

Emergency Department Psychiatric Documentation/Coding Outcomes 40

RebelEM

JUNE 12, 2024

Background and Physiology Shock secondary to beta-blocker (BB) or calcium-channel blocker (CCB) toxicity bears a tremendous degree of morbidity and mortality. 1 Recall that cardiac output is a function of both stroke volume and heart rate. 1 Recall that cardiac output is a function of both stroke volume and heart rate.

Poisoning 95

Poisoning Stroke Shock Administration 95

ACEP Now

OCTOBER 10, 2023

The CT scan reveals a hemorrhage in the right internal capsule, suggestive of acute hypertensive hemorrhagic stroke. Hospitals should incorporate this approach into clinical practice as part of active management for this serious condition.” Goal-directed resuscitation for patients with early septic shock. 2022;53(7):e282-e361.

Outcomes 52

Outcomes Stroke Emergency Department Hospitals 52

Taming the SRU

OCTOBER 25, 2023

100U (30-60 min prior), 0.25-0.375/100U

Blood Transfusions 98

Blood Transfusions Hospitals Stroke Anaphylaxis 98

ACEP Now

NOVEMBER 7, 2023

Out-of-hospital cardiac arrest unfortunately occurs relatively commonly and emergency physicians must be equipped to diagnose and treat this rapidly. The primary outcome was survival to hospital discharge. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. N Engl J Med.

Resuscitation 52

Resuscitation Hospitals Shock CPR 52

EB Medicine

AUGUST 1, 2018

Nachi: Sometimes… Jeff: This month’s issue was authored by Mollie Williams, who is the EM residency program director at the Brooklyn Hospital Center. Jeff: There are a shocking 22 million past-month users of marijuana in the US, followed by pain relievers at 3.8 First up is the link between cannabis use and stroke or TIA.

Seizures 40

Seizures Hyperthermia / Hypothermia Administration Dehydration 40

Taming the SRU

SEPTEMBER 1, 2023

Lane & Mcdonough Definition of an immediate whole body CT (iWBCT) scan Shortly after patient arrival. 2015) reported a sensitivity of 98.9%

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

Pediatric Emergency Playbook

JANUARY 1, 2017

Use soothing sensory measures: speak softly, offer a pacifier, and stroke the skin softly. Unexplained tachycardia may be the early signs of shock. Committee on Bioethics and Committee on Hospital Care. Neonate and Infant (0-12 months) Involve the parent, and have the parent visible to the child at all times if possible.

Pediatrics 40

Pediatrics Soft Tissue Injuries Burns Emergency Department 40

PulmCCM

MAY 22, 2023

In the TEAM trial conducted by the ANZICS group, 750 ICU patients in 49 hospitals in 6 countries were randomized to either early mobilization or usual care (which usually included in-bed physical therapy). g/kg per day) or usual dose (≥1.2 g/kg per day). At least one expert questioned whether the study was adequately powered.

Fluid Resuscitation 86

Fluid Resuscitation Resuscitation Hospitals Sepsis 86

Don't Forget the Bubbles

JULY 5, 2023

The Kilifi algorithm includes five clinical situations that are common sickle cell presentations – clinical jaundice, severe anaemia, bone and joint infections, and stroke. Symptoms may be non-specific in the beginning with patients quickly developing septic shock and disseminated intravascular coagulation. He is apyrexial.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126