Pediatric Education

FEBRUARY 4, 2024

The radiologic evaluation of an ultrasound examination showed a small hypoechoic mass in the area of right adrenal gland that was smaller than previously recorded prenatally. His abdominal examination was soft, non-tender without hepatosplenomegaly or identifiable masses. The diagnosis of a healthy male was made. Incidence: 0.28-0.55%

Ultrasounds 52

Ultrasounds Radiology Radiology Pediatrics 52

RebelEM

JANUARY 25, 2023

Radiology US 90% 96% 14.1 Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. 3.6 – 55.6) (-) LR: 0.13 (0.08 – 0.20) ED US (+) LR: 9.5 (2.1 0.27 – 0.83

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

ALiEM

SEPTEMBER 9, 2024

Patients are at high risk of bacterial spread to the abdomen or retrograde spread up the ventriculoperitoneal shunt leading to peritonitis, peritoneal abscess, ventriculitis, meningitis, or sepsis. Further indicated invasive/surgical interventions should be deferred to general surgery and neurosurgery consultants.

Sepsis 60

Sepsis Academics Operations Emergency Department 60

Pediatric Education

SEPTEMBER 10, 2023

The patient had a sepsis evaluation and was started on empiric antibiotics. The radiologic evaluation included a chest x-ray which showed suspected right-sided tracheal mass. Patient Presentation A term newborn male was transferred to the regional children’s hospital after having respiratory distress that developed after birth.

Pediatrics 40

Pediatrics Radiology Radiology Sepsis 40

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Pediatric status epilepticus is analogous to the multi-organ dysfunction syndrome in severe sepsis. Treatment: stabilization, embolization by interventional radiology, elective extirpation when more stable. This is the second reason to act quickly and avoid this kindling effect. In other words – time is brain.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

EB Medicine

JULY 8, 2019

Leakage from the staple line typically presents within the first week, but can present up to 35 days, usually with fevers, tachycardia, abdominal pain, nausea, vomiting sepsis, or peritonitis. Some may present with isolated tachycardia while others may present with profound sepsis – tachycardia, hypotension, and fever. At 6 to 8 mL/kg.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

PulmCCM

APRIL 10, 2025

SEPSIS Aspirin For Sepsis (ASP-SEPSIS trial) Could a simple aspirin help cure sepsis? Among 166 patients with “sepsis” who were randomized to aspirin 200 mg or placebo at five ICUs in Brazil, those receiving aspirin had no improvement in organ failure scores or other outcomes. Of course not.

CDC 40

CDC Stroke Sepsis Radiology 40

EM Literature of Note

OCTOBER 9, 2024

Does this patient require radiologic investigations? The clinician reviewers – one resident physician and one attending physician – did not much agree (73-83% agreement) on admission, radiology, and antibiotic determinations. The “sepsis measure fallout gestapo” might disagree, however.

Radiology 86

Radiology Radiology Emergency Department Documentation/Coding 86

EMDocs

OCTOBER 17, 2023

In patients with suspected ALCD, we suggest a complete assessment of the patients using clinical history, signs, laboratorial inflammation markers, and radiological findings (weak recommendation based on very low-quality evidence, 2D).” “In American College of Radiology ACR Appropriateness Criteria (2023) Left lower quadrant pain.

Radiology 93

Radiology Radiology Operations Best Practices 93

Northwestern EM Blog

MAY 16, 2022

vs. It is worth mentioning that this study was a multicenter study based in the US with representation from ED, Radiology, and Urology. Third, for those with proper training, and with some exceptions (see the systematic review paper for case vignettes that highlight these), POCUS is non-inferior to radiology-performed US.

Ultrasounds 52

Ultrasounds Radiology Radiology Outcomes 52

EMDocs

OCTOBER 10, 2024

Sepsis is diagnosed and antibiotics started for the first time. High level amputation is considered, but she dies of sepsis and multiorgan failure on hospital day 7. It reveals a 7.5 cm abscess in the R thigh and retro-cecal appendicitis with retro-peritoneal perforation. An I & D of the thigh produces foul-smelling pus.

Documentation/Coding 97

Documentation/Coding Hospitals Sepsis Infectious Diseases 97

EMDocs

MARCH 4, 2024

Now it is typically only employed if therapeutic procedures are anticipated, such as in patients with sepsis due to ascending cholangitis requiring biliary intervention for source control. Abdominal Radiology. Other complications include bleeding and perforation. Clinical Gastroenterology and Hepatology. 2021;19(1):24-40.

Emergency Department 105

Emergency Department Ultrasounds EMS Radiology 105

Mind The Bleep

AUGUST 5, 2023

Common signs and symptoms include: Abdominal distention with prominent veins and discolouration Umbilical flaring Poor feeding Bilious vomiting Abdominal tenderness Bowel changes, including diarrhoea, blood and mucus Lethargy, apnoea, bradycardia Sepsis Risk factors of low birth rate, prematurity and formula feeding. (1, Updated 2022 Aug 8].

Sepsis 52

Sepsis Ultrasounds Radiology Radiology 52

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. 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

RebelEM

OCTOBER 5, 2023

Background: Community-acquired pneumonia (CAP) can lead to pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and an increased risk of death. Pneumonia diagnosis supported by clinical and radiologic criteria. Population Inclusion Criteria: Adult patients (≥18 years old).

Research 94

Research Outcomes Administration Shock 94

RCEM Learning

NOVEMBER 28, 2022

In unresponsive menstruating women, examine the vagina for the presence of tampons left in place, they can cause delayed sepsis. Case courtesy of Dr Paul Clarke Learning bite Avoid unnecessary movement of the patient. DO NOT “spring” the pelvis on examination and DO NOT log-roll if pelvic injury suspected.

Fractures 40

Fractures Blood Transfusions Sepsis Operations 40

Taming the SRU

JUNE 6, 2023

MULLEN Case #1 Young male presenting with a left eye injury with concerns of wood particles in his eye On exam, reduced visual acuity and small amount of fluorescein uptake noted Initial concern for corneal FB First attempt for removal with a cotton swab Then called ophthalmology, who had concern for corneal laceration & subtle positive Seidel's (..)

Documentation/Coding 65

Documentation/Coding Seizures Psychiatric Wellness 65

Don't Forget the Bubbles

SEPTEMBER 23, 2024

Consider sepsis and treat it accordingly. Diagnosis is based on Epstein–Barr virus (EBV) in the blood, radiologic findings, and biopsy results. Changes in TAC concentrations related to changes in haematocrit should not lead to a prompt dose adjustment. CAKUT, catheterization requirement). When in doubt, call the team.

Pediatrics 52

Pediatrics Fractures Dehydration Sepsis 52