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EM@3AM: Murine Typhus

EMDocs

The disease is generally mild, but in untreated cases, it can lead to more severe outcomes, especially in patients with underlying conditions such as glucose-6-phosphate dehydrogenase deficiency. Even though the disease often resolves spontaneously, prompt antibiotic therapy is essential for optimal outcomes. 6, 2008, pp.

EMS 104
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"Sepsis bundles": No good evidence of benefit

PulmCCM

SEP-1 was pushed through without waiting for the outcomes of three ongoing multicenter trials testing goal-directed therapy for sepsis. The Infectious Diseases Society of America (IDSA) has consistently opposed SEP-1 since at least 2016. “thoracic” society has not taken a formal position that we are aware of.

Sepsis 59
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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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The 79th Bubble Wrap x Bristol Royal Hospital For Children

Don't Forget the Bubbles

This was a secondary outcome embedded in the Travel Fever study – a multi-centre, retrospective diagnostic accuracy study for imported malaria. 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.

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Diagnostics: Inflammatory Markers

Taming the SRU

Spinal Infection: According to the Infectious Disease Society of America’s (IDSA) 2015 guidelines for native vertebral osteomyelitis, CRP and ESR in the setting of protracted back pain have sensitivities ranging from 94 to 100% for ruling out infection and malignancy in these patients. J Arthroplasty. 2019 Feb;34(2S):S187-S195.

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AHA/NCS Statement on Critical Care Management of Post ROSC Patients

EMDocs

Systems included neurological, cardiac, pulmonary, hematology, infectious disease, gastrointestinal, endocrine, fluids management, and general critical care. In patients with enteral intolerance or shock, start with trophic EN (rates of 10–20 mL/h) and adjust according to tolerance (91%, 19/21).

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EM@3AM: ESBL-Producing Organisms and Their Management

EMDocs

Pressors where indicated for septic shock (typically Norepinephrine starting at 0.05 12 Complications Inadequate empiric therapy can lead to treatment delays and worse outcomes. Imipenem confers highest risk of seizures ESBL-E are often hospital acquired infections and can prolong hospital stay or lead to worse outcomes.

EMS 97