Don't Forget the Bubbles

MAY 17, 2023

This month’s list features answers to intriguing questions such as: ‘ Is the neonatal sepsis calculator useful if women were not screened for GBS? ’, ‘ Who can best score postoperative pain: parents or the children? ’, ‘ Is functional constipation associated with hypohydration? Diagnosis and Management of Pituitary Adenomas: A Review.

Pediatrics 72

Pediatrics X-Ray Interpretation Sepsis Fractures 72

Taming the SRU

AUGUST 30, 2023

Significantly elevated CRP (>122mg/L) and PCT (>0.5ng/mL) levels are predictors of bad outcomes, and are useful for tracking therapy progress, but are not specific enough to rule-in infectious endocarditis [38-39]. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear.

Infectious Diseases 89

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

RebelEM

MARCH 27, 2023

Ventilator-associated lung injury and inflammation can occur even during short-term mismanagement can worsen patient outcomes. 4 Using factors such as shock, pneumonia, and sepsis this score allows an accurate prediction of developing ARDS. This is a critical error that leads to poorer outcomes for patients in need of critical care.

Emergency Department 52

Emergency Department Operations Academics Documentation/Coding 52

ACEP Now

JULY 7, 2024

Although they may not appear as physically injurious as convulsive seizures, nonconvulsive seizures can significantly impact the neurological outcomes and overall prognosis of patients in critical care settings. Early and established status epilepticus: the impact of timing of intervention, treatment escalation and dosing on outcome.

Seizures 52

Seizures Emergency Department Outcomes EMS 52

RebelEM

NOVEMBER 3, 2022

Outcomes: Primary Outcome: Incidence of post-induction hypotension Secondary Outcome : First-pass success rate of endotracheal intubation Primary Results: 84 articles were identified for potential inclusion. Articles removed were duplicates, contained irrelevant outcomes, or had a significant risk for bias.

Emergency Department 52

Emergency Department Outcomes Sepsis Operations 52

PulmCCM

JANUARY 4, 2022

” -Fran Lebowitz Background Quite recently, the BaSICS investigators evaluated the infusion rate of a fluid bolus on patient outcome. The primary outcome was identification of the optimal volume for assessing fluid responsiveness. If I get to the dry cleaners without having a huge fight, that’s challenging enough.”

Wellness 40

Wellness Outcomes Sepsis Stroke 40

EB Medicine

JULY 8, 2019

Nachi: Unfortunately this procedure is associated with a relatively high re-operation rate – one study found 20% of patients required removal or revision. Jeff: Even more shockingly, some series showed a 52% repeat operation rate. These patients often require emergent operative intervention. At 6 to 8 mL/kg.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ACEP Now

JANUARY 5, 2025

1 The primary outcome was the frequency of observed hypoxemia, defined as any pulse oximetry reading below 85 percent. Serious patient-oriented outcomes such as cardiac arrest were rare, but almost all occurred in the oxygen mask cohort. The obvious winner was NIPPV, whose 9.1 3 The machine learning model trailed just behind.

Sepsis 40

Sepsis Research Airway Management Stroke 40

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. vs. 0.91), positive predictive value (0.27

Sepsis 93

Sepsis Fluid Resuscitation Resuscitation Shock 93

The Skeptics' Guide to EM

DECEMBER 14, 2024

Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. Is this pneumonia or could this be sepsis? Background: Pediatric sepsis is a major global health concern, causing an estimated 3.3 Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock.

Sepsis 103

Sepsis Pediatrics Shock Hospitals 103

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome measure was chest drain failure, i.e., retained haemothorax requiring a secondary interventional procedure. They stratified patients according to the ratio of FFP: PRBC received (1:1, 1:2, 1:3 and 1:3+) and performed logistic regression analyses for various outcomes.

Resuscitation 139

Resuscitation Operations Sepsis Pediatrics 139

Northwestern EM Blog

MAY 16, 2022

Do outcomes for patients with suspected nephrolithiasis differ based on the initial imaging? However, with ultrasonography becoming more prevalent in EDs, it may be possible that initial imaging may avoid this radiation risk and still have similar outcomes for patients. Would you be satisfied with only US and no follow-up CT?

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

EMDocs

OCTOBER 23, 2023

Operative complications requiring surgical intervention or hospitalization occur in about 3-6% of all hysterectomies (5). difficile infection, and post-operative hemorrhage. Abscess and Infected Hematoma : This condition is typically delayed, occurring most commonly 10-14 days post-operatively.

OB/GYN 94

OB/GYN Operations EMS Ultrasounds 94

RebelEM

AUGUST 12, 2024

What They Did: Double-blind, randomized, placebo controlled trial that ran from October 2019 through January 2024 Multinational study conducted at 22 centers in three European countries 3512 patients were enrolled and before surgery eligible patients were randomly assigned to one of the following two groups Amino Acid Group: 10% Isopuramin at a dose (..)

Outcomes 81

Outcomes Hospitals Operations Shock 81

Taming the SRU

JUNE 11, 2023

Utilized in the pre-hospital setting, ICU and the Operating Room, it is a non-invasive measurement that reflects a patient’s current state of metabolism, circulation and ventilation. The primary outcome was in-hospital mortality. The secondary outcome focused on ICU admissions. The treatment team was blinded by these values.

Hospitals 88

Hospitals Emergency Department EMS Outcomes 88

EMDocs

OCTOBER 17, 2023

CT is the most useful examination for patients with suspected complications of colonic diverticulitis because of its reproducibility, superior diagnostic accuracy (98%)m accuracy for alternative diagnoses with a similar presentation, risk-stratification of patients for operative versus nonoperative treatment, and inpatient versus outpatient triage.

Radiology 95

Radiology Radiology Operations Best Practices 95

ACEP Now

MARCH 6, 2024

The PATCH-Trauma trial took a critical look at TXA in major trauma in the advanced trauma systems of Australia and found a mixed result: a slightly greater number of patients were still alive six months following TXA administration, but there was no difference in survival with a good functional outcome. percent to 38.3

Research 52

Research Airway Management Stroke Outcomes 52

ACEP Now

MAY 9, 2024

A search for Brazilian Butt Lift (BBL) on any social media platform will yield thousands of before-and-after images, faja sales, operating room videos, recovery tips, and patients praising their plastic surgeon. These questionable practices led to a rash of bad outcomes.

Emergency Department 52

Emergency Department Operations Ultrasounds Shock 52

PulmCCM

FEBRUARY 28, 2022

Death, from any cause, within 90 days of randomization was the primary outcome. There were multiple secondary outcome measures that related to acute kidney injury, hemodynamic stability and respiratory failure. There was no statistically or clinically-significant difference in any of the primary or secondary outcomes.

Fluid Resuscitation 40

Fluid Resuscitation Resuscitation Outcomes Sepsis 40

EB Medicine

JUNE 6, 2019

Nachi: And remember that hypothermic patients who are septic have worse outcomes than those who are hyperthermic and septic. However, it can also be due to hypoxia, sepsis, anemia, PE, or metabolic acidosis, so consider all of those also in your differential. was sensitive for 28-day mortality in sepsis.

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Don't Forget the Bubbles

JANUARY 13, 2025

Often, these babies are managed as more common neonatal illnesses initially, such as persistent pulmonary hypertension of the newborn, sepsis, or respiratory distress syndrome. Neonates with significant obstructed TAPVD will require intubation, ventilation and inotropic support pre-operatively. An echo is generally diagnostic.

Operations 59

Operations Outcomes Pediatrics EKG/ECG 59

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane). for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

EMDocs

JANUARY 16, 2025

Today we cover the Phoenix Sepsis Criteria. years Best performing criteria identified by AUPRC and AUROC 4-organ-system model translated into the Phoenix Sepsis Score had best mortality prediction characteristics AUPRC of 0.23-0.38 Well provide summaries of the evidence to support your decisions at the bedside. but PPV ranges from 25.1-39.5%

Sepsis 96

Sepsis Pediatrics Shock Hospitals 96

EMDocs

APRIL 1, 2025

Ultimately theres thrombus formation => obstructs venous drainage which can lead to cranial nerve compression, sepsis, death. thrombophilia, head/neck operation or trauma, dehydration, etc.) Several studies have found reduced mortality and improved neurologic outcomes with anticoagulation (UFH or LMWH) (4-6).

Dehydration 100

Dehydration Sepsis Seizures Resuscitation 100

Don't Forget the Bubbles

JANUARY 1, 2024

However, children who had an operation experienced improvements in behaviour, symptoms, and quality of life and had lower blood pressure. 2023 Dec 12 Pediatric Sepsis Diagnosis, Management, and Sub-phenotypes. Outcomes From a Randomized Clinical Trial. They enrolled 459 children aged 3 to 12.9 Pawlowski TW, et al. Eur J Pediatr.

Pediatrics 98

Pediatrics Ultrasounds Blood Transfusions Sepsis 98

Don't Forget the Bubbles

DECEMBER 9, 2024

Clinical recommendations for pain, sedation, withdrawal, and delirium assessment in critically ill infants and children Pediatric Acute Lung Injury and Sepsis Investigators ( PALISI ). Incidence, associated factors, and outcomes of delirium in critically ill children in China: a prospective cohort study. Am J Respir Crit Care Med.

Pediatrics 59

Pediatrics Sepsis Hospitals Administration 59

Don't Forget the Bubbles

SEPTEMBER 23, 2024

suprapubic catheters, gastrostomy tubes, haemodialysis or peritoneal dialysis lines – may have been left in situ in the initial post-operative period), and central vascular catheters. Look for scars indicating previous central lines, peritoneal dialysis catheters or operations. Consider sepsis and treat it accordingly.

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52

Don't Forget the Bubbles

JULY 5, 2023

Furthermore, educating both patients and their families is important in order to achieve good treatment compliance and better clinical outcomes. Afro-Caribbean patients should be screened for sickle cell before anaesthesia for possible pre-operative transfusion. What could be the differential diagnosis? pneumoniae and S.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126