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. health system require us to enter a diagnosis to generate payment by a health insurer, it’s worth emphasizing that sepsis is a syndrome, not a disease.

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Sepsis Shock Research Wellness 45

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. We have a special episode for you this month… We’ve brought Dr. Jeremy Rose, one of the peer reviewers, and a sepsis expert, on with us to talk through the content this month. Jeff : Sepsis chair. Sepsis-3!!

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Sepsis Shock Fluid Resuscitation Hospitals 40

Taming the SRU

APRIL 17, 2024

The surviving sepsis guidelines weakly recommend invasive arterial blood pressure monitoring (IABP) over noninvasive blood pressure monitoring (NIBP) with a blood pressure cuff supported by low quality evidence.(1) Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.

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Sepsis Research Stroke Academics 94

Don't Forget the Bubbles

MARCH 4, 2024

Article 1: Infections in Foreign Travellers Bird C, Hayward GN, Turner PJ, Wasala D, Merrick V, Lyttle MD, Mullen N, Fanshawe TR; for Paediatric Emergency Research in the UK and Ireland (PERUKI). Reviewed by: John Coveney Article 2: How do we define sepsis in children? Paediatr Int Child Health. 2024 Jan 11:1-7. doi:10.1001/jama.2024.0179

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Hospitals Sepsis Fractures Emergency Department 78

JournalFeed

MARCH 23, 2024

Tuesday Spoon Feed: This Bayesian network meta-analysis of RCTs indirectly compares hydrocortisone + fludrocortisone to hydrocortisone alone or placebo in septic shock and finds superiority with the combination regimen.

Sepsis 52

Sepsis Shock Research 52

University of Maryland CC Project

SEPTEMBER 1, 2024

His particularly research […] Dr. Jayshil Patel is an associate professor at the Medical College of Wisconsin and a board certified physician in internal medicine, pulmonary medicine, and critical care medicine.

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Shock Research 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. Strengths: The investigators framed a research question centered on patient outcomes, ensuring the study’s relevance and practicality.

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Research Outcomes Administration Shock 94

AENJ: Current Issue

MAY 8, 2024

This column on translating research into practice is crafted to offer advanced practice registered nurses an analysis of current research topics that hold practical relevance for emergency care settings.

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Emergency Department Outcomes Sepsis Research 40

RebelEM

OCTOBER 31, 2022

Vitamin C can function as an antioxidant and may mitigate endothelial oxidative stress in sepsis. Amrein 2018) A small, single-center, before-and-after study utilized a sepsis cocktail consisting of IV thiamine, hydrocortisone, and vitamin C and discovered a significant decrease in mortality compared to the control group.

Sepsis 52

Sepsis Outcomes Research Shock 52

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

Carly Eastin is an Associate Professor, Division of Research and Evidence Based Medicine, Department of Emergency Medicine, University of Arkansas for Medical Sciences. Case: A 45-year-old female in the emergency department is being admitted to the intensive care unit (ICU) for septic shock secondary to urinary tract infection (UTI).

Sepsis 52

Sepsis Shock Outcomes Stroke 52

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Following the triage sepsis pathway, recently amended to use qSOFA.

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Sepsis Emergency Department Seizures Pediatrics 52

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Infectious Diseases 52

Northwestern EM Blog

JANUARY 24, 2022

Written by: Elizabeth Stulpin, MD (NUEM ‘23) Edited by: Aaron Wibberly, MD (NUEM ‘22) Expert Commentary by : Joshua Zimmerman, MD (NUEM ‘17) Non-Response to Vasopressors Shock is defined as a state of cellular and tissue hypoxia resulting in end organ dysfunction. And for most forms, EM physicians are not typically shocked by shock.

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Anaphylaxis Shock Sepsis Resuscitation 52

Pediatric Emergency Playbook

APRIL 1, 2016

Lactate A sick child with sepsis syndrome? In the adult literature, we know that a lactate level above 4 mmol/L in patients with severe sepsis was associated with the need for critical care. The acute recognition and treatment of sepsis is first and foremost, clinical. We should use lactate to detect occult shock.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

The Skeptics' Guide to EM

DECEMBER 11, 2021

Date: December 10th, 2021 Guest Skeptic: Dr. Carly Eastin is an Associate Professor, Division of Research and Evidence Based Medicine, Department of Emergency Medicine, University of Arkansas for Medical Sciences. Back in 2019 we were talking about Vitamin C for sepsis ( SGEM#268 ). Not much has changed over the last two years.

Sepsis 40

Sepsis Shock Outcomes Research 40

Northwestern EM Blog

FEBRUARY 14, 2022

The ATHOS-3 trial in 2017 explored the efficacy of angiotensin II as a vasopressor for severe vasodilatory shock. Severe shock is defined as persistent hypotension requiring vasopressors to maintain a mean arterial pressure of 65mmHg and serum lactate <2 despite adequate volume resuscitation.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

The Skeptics' Guide to EM

JULY 16, 2022

Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. She is admitted to the intensive care unit (ICU) for septic shock. Date: July 16th, 2022 Reference: Lamontagne F et al. Guest Skeptic: Dr. Salim R. Guest Skeptic: Dr. Salim R.

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Sepsis Shock Outcomes EMS 40

EMDocs

JULY 1, 2023

Upon further research in the 1970’s, retrospective data from autopsies of those patients showed coronary aneurysms 5 Pathophysiology: Kawasaki Disease is a vasculitis of medium sized arteries.

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EMS Infectious Diseases Pediatrics Research 94

Thinking Critical Care

MAY 18, 2023

In 1983 I was an Englishman abroad, the London anaesthetist who was appointed to be the English anaesthetist on the Shock Team only because the outstanding candidate from Oxford had preferred to take up a job doing muscle relaxant research with Kitz and Katz in the USA. 4] The research agenda at the time was broad.

Shock 40

Shock Research Sepsis Resuscitation 40

Don't Forget the Bubbles

JANUARY 10, 2024

The factorial design chosen by Dr Maitland and her research group means that several comparisons in transfusion practice could be carried out at the same time. What were the research questions? Does the study address a clearly focused research question? N Engl J Med. 2019;381(5):407-419. Was blinding achieved?

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Blood Transfusions Research Outcomes Hospitals 78

Don't Forget the Bubbles

NOVEMBER 15, 2023

Jasmine, a hypothetical case Jasmine is a 5-year-old girl weighing 18kg admitted to PICU with suspected sepsis. She had septic shock on presentation and was resuscitated with 60ml/kg of balanced crystalloid solution and escalating vasoactive medications. Remember, we can add more if needed, but taking it away is much harder.

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Resuscitation Dehydration Administration Shock 80

Mind The Bleep

FEBRUARY 27, 2024

2] Since this data was published the APLS guidelines have altered to reflect these results and the need for more research in this area and now recommend the 10ml/kg boluses as above compared to the previous recommendation of 20ml/kg. saline), however more research is needed in this area. [4] Which type of fluid to use?

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Fluid Resuscitation Hospitals Dehydration Research 96

The Skeptics' Guide to EM

FEBRUARY 10, 2018

Exclusions: Oxygen saturations <92% on room air; silent chest; shock or sepsis; previous PICU admission with wheeze; prematurity; other cardiac or respiratory disease; likely alternative diagnosis for the wheeze; or steroid treatment within the preceding 14 days.

Emergency Department 40

Emergency Department Pediatrics Sepsis Hospitals 40

Dr. Smith's ECG Blog

MAY 19, 2020

In this case, profound shock for 1 hour would result in the same degree of infarction. The Type 2 MI would then have been a result of the prolonged severe shock while in arrest. If the arrest had another etiology (such as old scar), and the ST elevation is due to severe shock, then it is a type II STEMI. Troponin I rose to 44.1

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CPR EKG/ECG Shock Ultrasounds 52

EB Medicine

MARCH 4, 2020

Literature Review: There is abundant literature on pediatric AGE but sparse research on AGE in adults. Stool Cultures: 2017 IDSA guidelines recommends them in patients with fever, bloody or mucoid stools, severe abdominal cramping or tenderness, or signs of sepsis, noting these patients are at higher risk of bacterial infection.

Emergency Department 40

Emergency Department Dehydration Poisoning Allergic Reactions 40

PulmCCM

JANUARY 4, 2022

As well, the volume of administration might be much lower than 500 mL, with previous research indicating that 4 mL/kg of crystalloid was an optimal volume needed to increase mean systemic filling pressure. Yet, studies of fluid challenges have actually investigated greater rates of infusion including 50 mL in 10 seconds !

Wellness 40

Wellness Outcomes Sepsis Stroke 40

Taming the SRU

MAY 1, 2023

EMS was bagging him on arrival Primary notable for Compromised Airway Protection, bilateral Breath sounds, strong pulses,GCS 3 CT images of Head, Chest, Abdomen, Pelvis, and Spine No acute findings pH of 6.75

Poisoning 52

Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

RebelEM

NOVEMBER 3, 2022

It is unclear if researchers followed specific validated systematic review process guidelines such as PRISMA. The groups were unbalanced, with more patients with sepsis and more patients with difficult airway characteristics in the ketamine group. Limitations: Non-English papers were excluded.

Outcomes 52

Outcomes Emergency Department Sepsis Operations 52

EMDocs

DECEMBER 18, 2023

Septic shock is high on the differential diagnosis for this patient’s presentation. 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. vs. 0.91), positive predictive value (0.27

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Sepsis Fluid Resuscitation Resuscitation Shock 93

RebelEM

MAY 15, 2024

Antibiotics are effectively the only thing standing between these patients and overwhelming sepsis. Improving the immediate management of neutropenic sepsis in the UK: Lessons from a national audit. BMC Health Services Research. Neutropenic Fever: Fever (one reading of 38.3C Support Care Cancer. 2018 May;26(5):1465-1470.

Infectious Diseases 98

Infectious Diseases Administration Sepsis Anaphylaxis 98

Don't Forget the Bubbles

OCTOBER 2, 2024

We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Corticosteroids for Managing Pediatric Sepsis and Septic Shock: A Systematic Review and Meta-analysis. Wyrwa JM, et al. Pediatrics. Deng J, et al. 2024 Sep 25.

Pediatrics 52

Pediatrics Hyperthermia / Hypothermia Emergency Department Urgent Care 52

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%

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Sepsis Pediatrics Shock Hospitals 96

Sensible Medicine

AUGUST 14, 2024

Researchers comb through the victims’ genomes for mutations in cardiorespiratory function and autonomic arousal systems. This sort of sepsis would produce many of the common autopsy findings. Scientists have found dozens of mutations in babies with SIDS deaths , but no clear answer. Dr. Paul N.

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CDC Sepsis Research Pediatrics 92

Don't Forget the Bubbles

FEBRUARY 24, 2025

Because of this possible diagnosis, they were commenced on a macrolide antibiotic (azithromycin) in addition to treatment for neonatal sepsis +/- meningitis (ceftriaxone and acyclovir). Post-ET, careful monitoring is essential, particularly for secondary bacterial infections and sepsis.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

PulmCCM

JANUARY 2, 2025

A large proportion have concluded PCT is a safe and effective method to shorten antibiotic courses, including in patients with sepsis. The ADAPT-Sepsis Trial Between 2018 and 2024 at 41 centers in the U.K., Because ADAPT-Sepsis was designed as a noninferiority trial, and the authors chose (arbitrarily) a 5.4%

Sepsis 98

Sepsis Outcomes Stroke Shock 98

PulmCCM

NOVEMBER 11, 2024

Severe bleeding, limb ischemia, and sepsis with bacteremia were also increased in the Impella group, with the composite outcome of adverse events occurring four times more often in Impella patients (24% vs 6%). But while the number needed to save a life was 8, the number needed to harm in DanGer-Shock was 6.

Shock 98

Shock Sepsis Outcomes Research 98

EMDocs

JANUARY 20, 2025

Sepsis There has been much controversy over the last two decades around the various nuances of volume resuscitation in ED patients with suspected sepsis, much of which goes beyond the scope of this limited review. Patients were enrolled in these trials if they had signs of shock, with mortality ranging from 18-29%. Inwald et al.

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Dehydration Fluid Resuscitation Sepsis Resuscitation 75