Taming the SRU

FEBRUARY 5, 2024

The LP is now a standard procedure and in 2010 well over 135,000 LPs were performed in Emergency Departments throughout the US (3). As may be seen in the table below, there are several themes as well a range of stringency. Scandinavian journal of infectious diseases , 45 (9), 657–663. WHO - Who Needs an LP in the ED?

Infectious Diseases 96

Infectious Diseases Seizures Ultrasounds Sepsis 96

NIOSH Science Blog

AUGUST 4, 2020

However, during widespread respiratory infectious disease outbreaks, there may be a need to implement respirator extended use practices due to an inadequate supply of FFRs. Skin irritation caused by disposable FFR use for extended periods of time has been documented during past outbreaks of respiratory infectious diseases.

Infectious Diseases 49

Infectious Diseases Documentation/Coding Wellness 49

PEMBlog

OCTOBER 18, 2023

The night prior to presentation, mom noticed he was not feeding as well and seemed fussy. Initially in the emergency department he was generally well-appearing with normal vital signs. Infants with NTED generally remain well-appearing and do not meet toxic shock syndrome (TSS) criteria. Overnight, she had to wake him to feed.

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

Pediatric EM Morsels

AUGUST 18, 2023

(Jackson 2016) It can also be used in UTIs , but is typically reserved for special cases where the infectious bacteria is found to be multidrug resistant or in complicated UTIs. BMC Infectious Disease. PMID: 26407358 Meesters K, Mauel R, Dhont E, Walle JV, De Bruyne P. PMID: 29471791 Morley C, Carvalho de Almeida C, Moloney S.

Pediatrics 130

Pediatrics Infectious Diseases Seizures Hospitals 130

Pediatric EM Morsels

DECEMBER 20, 2024

Keep in mind, there can be extrapulmonary manifestations as well! These include: Mucocutaneous disease including rashes like erythema multiforme, mycoplasma induced rash and mucositis (AKA reactive infectious mucocutaneous eruption RIME), and SJS.

CDC 161

CDC Seizures Pediatrics EMS 161

American Medical Compliance

FEBRUARY 23, 2023

The Employees Returning to Work Infection Control Compliance (ICC) course is designed to educate employees on how to protect themselves and others and mitigate community transmission of infectious diseases. They reduce the spread of infectious diseases in the workplace. ICC training sets industry standards.

Infectious Diseases 52

Infectious Diseases PPE CDC Best Practices 52

ACEP Now

FEBRUARY 11, 2024

He noted spending about five days walking through a jungle, as well as traversing rivers. There was concern for possible cutaneous leishmaniasis (CL), therefore he was admitted to the hospital for infectious-disease and surgical consultations, as well as to complete a punch biopsy the following day. Click to enlarge.)

Infectious Diseases 52

Infectious Diseases CDC Military Emergency Department 52

PulmCCM

FEBRUARY 5, 2024

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. Ultrasound is well-suited for identifying most serious biliary system abnormalities.

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

Taming the SRU

AUGUST 6, 2023

Kletsel Pustular psoriasis Psoriasis is characterized by discrete plaques of erythema, scales, and fissures of the extremities It is associated with significant morbidity & treatment consists of topical steroids, along with referral to establish with dermatology Use caution with systemic steroids as they can potentially worsen flares While rare, (..)

Infectious Diseases 83

Infectious Diseases Pediatrics Fractures Wellness 83

ACEP Now

MAY 10, 2024

Patients with flank pain (which would suggest pyelonephritis) as well as patients meeting two or more SIRS criteria (which would suggest sepsis) comprise a higher risk group. Clinical Infectious Diseases. Let’s look at three young female patients with differing symptom severities. link] Cai T, Mazzoli S, Mondaini N, et al.

Infectious Diseases 98

Infectious Diseases Sepsis Administration Emergency Department 98

Mount Sinai EM

JULY 27, 2023

sickle cell anemia) Hyposplenia (from atrophy, infarction, engorgement, or infiltration of the spleen in chronic dz such as thalassemias, chronic liver disease, HIV/AIDs, immune disorders, or malignancies) If splenic function is in question, you can obtain a peripheral blood smear and check for Howell-Jolly bodies.

Sepsis 182

Sepsis Wellness Infectious Diseases 182

EMDocs

APRIL 27, 2024

Infectious diseases , 4 (1), 34–39. Infectious diseases, 4(1), 34–39. and Staphylococcus spp. 2 F ungal involvement (usually Aspergillus fumigatus ), especially in immunocompromised patients. The changing face of malignant (necrotising) external otitis: clinical, radiological, and anatomic correlations. The Lancet.

EMS 84

EMS Infectious Diseases Radiology Radiology 84

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. What is it?

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

Taming the SRU

JUNE 12, 2023

However, there have been no studies statistically powered well enough regarding dog bite lacerations to confirm or dispute this claim. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clinical Infectious Diseases.

Infectious Diseases 102

Infectious Diseases Emergency Department Administration Academics 102

EM Curious

JULY 8, 2015

More FOAMed INFECTIOUS DISEASE SMORGASBORD CORE EM PODCAST EPISODE 3 [PODCAST]: Swami sits down to run over some high yield EM topics in the arena of infectious disease, from antibiotic choice in HCAP, to new paradigms in soft tissues infectious. Well, this may not be completely true.

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

RCEM Learning

APRIL 9, 2024

Maintain a Positive Mindset and Well-being: Exam preparation can be demanding, so it’s important to take care of your mental and physical well-being. A positive mindset and well-being contribute to better focus and performance during the exam.

Infectious Diseases 52

Infectious Diseases Airway Management Resuscitation Poisoning 52

PulmCCM

NOVEMBER 6, 2023

Intuitively, plasma seemed even less likely to help the very sickest of the sick— those mechanically ventilated with ARDS from Covid-19, whose mortality rate was well over 50% at many centers. Convalescent plasma, it was concluded, didn’t help patients with severe Covid-19 as a general group. Only it turns out, it did help.

Blood Transfusions 98

Blood Transfusions Operations Resuscitation Infectious Diseases 98

Taming the SRU

AUGUST 30, 2023

As the name would suggest, inflammatory markers are biological markers of, well, inflammation. A 2015 meta-analysis of 9 studies consisting of 725 patients published in the International Journal of Infectious Diseases found PCT far superior to CRP, with PCT having a sensitivity of 90 and specificity of 98% [36]. J Arthroplasty.

Infectious Diseases 87

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 87

EM Ottawa

SEPTEMBER 28, 2023

He looks well by ED standards. You are treating a 43-year-old male with two days of left lower quadrant abdominal pain, a documented fever of 38.4 and malaise. He has no urinary or bowel symptoms. His past medical history is unremarkable. After a focused history and physical examination, you narrow the differential to diverticulitis.

Documentation/Coding 112

Documentation/Coding Wellness Infectious Diseases EMS 112

American Medical Compliance

JUNE 16, 2023

Needlesticks are causing patients to be infected with unwanted diseases. This raises concerns about how providers store needlesticks as well as protect patients and healthcare workers alike. It is important to do what is necessary to prevent needlestick infections and accidental contact with potentially dangerous needlesticks.

CDC 52

CDC Infectious Diseases Wellness 52

American Medical Compliance

FEBRUARY 2, 2024

Use of the ATD Standard Cal/OSHA requires employers covered by the Aerosol Transmissible Disease (ATD) Standard (California Code of Regulations, Title 8, Section 5199) to protect employees from airborne infectious disease such as COVID-19 and pathogens transmitted by aerosols.

Infectious Diseases 52

Infectious Diseases Documentation/Coding PPE Wellness 52

Cook County EM Blog

MARCH 31, 2022

Rabies, a neurotropic lyssavirus in the family rhabdoviridae, presents as a progressive encephalopathy known to have the highest case fatality rate of all known infectious diseases. As a sobering reminder, the appearance of the clinical signs and symptoms of rabies herald an almost certain death.

Infectious Diseases 52

Infectious Diseases Administration Wellness 52

Pediatric Education

MAY 26, 2024

The pediatrician said that the child was overall healthy and thriving, with the usual minor infectious disease episodes. “I reassured the mother that he was doing well and he should have fewer infections as he grew. The child only called the mother and professional by ma-ma. but not for injuries.

Infectious Diseases 40

Infectious Diseases Pediatrics Outcomes Wellness 40

Pediatric EM Morsels

OCTOBER 6, 2023

(Forster, 2021) Transmission is by Fecal-Oral route (Chiodini 2018) Incubation period 6-30 days after exposure (Chiodini 2018) Salmonella typhi produces an endotoxin although its clinical significance is not yet well understood (Gibani 2019) Two typhoid vaccines are available for those > 6 m/o and are 50-80% effective.

Pediatrics 161

Pediatrics CDC Seizures Documentation/Coding 161

American Medical Compliance

AUGUST 7, 2024

PPEs that OSHA mandates minimize exposure to infectious diseases, ensuring that healthcare workers are adequately protected during patient care. It protects the health and well-being of staff. Additionally, OSHA guidelines require the proper handling and disposal of hazardous materials.

Hazardous Materials 80

Hazardous Materials Documentation/Coding Legal Issues Patient Safety 80

RebelEM

FEBRUARY 29, 2024

Patient data anonymized when presented to adjudication committee to avoid detection bias Well-balanced patient characteristics between groups. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 Medication prepared by nurses in another unit not involved in the patients’ care.

CDC 125

CDC Radiology Radiology Outcomes 125

EMDocs

JULY 1, 2023

Early consultation with a specialist is recommended in these cases 7,8 Workup: Lab tests can support the diagnosis of KD, especially in incomplete KD cases as above. He has had a high fever of > 103°F (39.4°C) C) for the past week.

EMS 66

EMS Infectious Diseases Pediatrics Research 66

Pediatric EM Morsels

AUGUST 11, 2023

Having authored 575 ( well, now 576 ) of them, I am often quite convinced that there are no new topics to discuss. This is the 601st Ped EM Morsel ! Then July happens and we get 14 more amazing interns who help educate me and remind me that there is always more to learn.

Burns 130

Burns Pediatrics EMS Outcomes 130

ACEP Now

JANUARY 12, 2024

7 Postvoid residual urine volume and levels of prostate-specific antigen are useful for diagnostic purposes, as well as possible CT scan or ultrasound to evaluate for an enlarged and inflamed prostate. Current Opinion in Infectious Diseases. 6 Some studies estimate that E. In: Linn WD, Wofford MR, O’Keefe ME, et al.,

Infectious Diseases 52

Infectious Diseases Ultrasounds Wellness Hospitals 52

Dr. Mike Sevilla

FEBRUARY 10, 2022

Of course, you were like me, saying to yourself, “Well, we will chat again soon.” Of course, from an infectious disease standpoint, I understood its importance. Are there long time friends that you just haven’t talked with since the start of the pandemic? Or, “One of these days I’ll give them a call again.” Two long years.

Infectious Diseases 52

Infectious Diseases Wellness 52

RCEM Learning

APRIL 9, 2024

Take care of your physical and mental well-being, and ensure you get adequate rest and relaxation. Stay Calm and Confident: Prior to the exam, maintain a calm and positive mindset. Build your confidence by regularly practicing SBA questions and reinforcing your knowledge.

Infectious Diseases 52

Infectious Diseases Airway Management Dislocations Poisoning 52

Total Medical ComplianceHIPAA

OCTOBER 9, 2024

This list is not all inclusive, there may be other challenges as well. Keep in mind that persons involved in the clean up need to be protected from infectious diseases, chemical exposures, radiation, electrical shock, and potential fire hazards. Determine if water is deemed safe to use and there is a sufficient supply of water.

Hazardous Materials 59

Hazardous Materials Infectious Diseases PPE Shock 59

Don't Forget the Bubbles

SEPTEMBER 18, 2024

. ■ Case 1 focuses on a case seen in the emergency department and explores the common parental query of a “weak immune system” in a young child who has had several recurrent upper respirator tract infections back-to-back but is otherwise well. His parents are both fit and well and there is no family history of any medical conditions.

Emergency Department 98

Emergency Department Wellness Infectious Diseases Pediatrics 98

Pediatric Education

NOVEMBER 19, 2023

They felt he was breastfeeding well and had only mild jaundice. His examination was normal and the diagnosis of a well newborn infant was made. mg/dL which was well below treatment threshold. Some infants may need car seat tolerance screening as well. The laboratory evaluation of a transcutaneous bilirubin was 8.4

Infectious Diseases 40

Infectious Diseases Administration Pediatrics Wellness 40

Pediatric Education

OCTOBER 8, 2023

The diagnosis of a healthy female was made who would be traveling to an area endemic for several infectious diseases. The pediatrician consulted the Centers for Disease Control website for vaccine recommendations for the Congo which indicated the need for malaria prophylaxis as well as Yellow Fever and Typhoid vaccine.

Infectious Diseases 40

Infectious Diseases Pediatrics Military Wellness 40

EM Literature of Note

SEPTEMBER 13, 2024

Most regions used a strategy in which nirsevimab was provided to new births during RSV season, as well as other young infants born prior to the onset of the season. The two “COVID seasons” of 2020-21 and 2021-22 were excluded from their comparisons.

Emergency Department 85

Emergency Department Pediatrics Administration Wellness 85

ALiEM

DECEMBER 9, 2024

Physical Exam Vitals : BP 128/84; HR 88; Temp 98F; RR 18; SpO2 (on RA) 100% General : Well appearing HEENT : No conjunctival injection Cardiovascular : S1, S2; no murmurs, rubs, or gallops Skin : Erythematous patch with central clearing in left popliteal fossa Laboratory Data WBC : 5.1 Platelets : 223 Sodium : 139 Creatinine : 0.8

Emergency Department 60

Emergency Department CDC EMS Academics 60