PHEM Cast

APRIL 10, 2016

[link] We hope you enjoyed our sepsis podcast. St Emlyns Induction podcast on Sepsis. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. March 2016.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

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!!

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

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

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 92

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.

Shock 40

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.

Emergency Department 40

Emergency Department Outcomes Sepsis Research 40

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

Don't Forget the Bubbles

NOVEMBER 18, 2024

Various studies, such as those pooling data from the National Neonatal Research Database, indicate that the incidence of hypotension varies based on neonatal age, with the highest rates observed immediately post-birth and within the first days of life. Hypotension in the setting of sepsis may be one of the first signs of a systemic infection.

Sepsis 59

Sepsis Shock Hyperthermia / Hypothermia Administration 59

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.

Sepsis 52

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 Outcomes 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.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

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.

CDC 73

CDC Sepsis Research Pediatrics 73

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

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?

Blood Transfusions 78

Blood Transfusions Outcomes Research Hospitals 78

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.

Sepsis 40

Sepsis Shock Outcomes EMS 40

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

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

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.

EMS 66

EMS Infectious Diseases Pediatrics Research 66

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

CPR 52

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

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

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 Emergency Department Seizures 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 Hospitals 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

Sepsis 66

Sepsis Fluid Resuscitation Resuscitation Shock 66

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

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

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

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?

Fluid Resuscitation 96

Fluid Resuscitation Hospitals Dehydration Research 96

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 104

Infectious Diseases Administration Sepsis Anaphylaxis 104

Don't Forget the Bubbles

JULY 3, 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. Trends in C-Reactive Protein Use in Early-Onset Sepsis Evaluations and Associated Antibiotic Use. Pediatrics. 2024 Jun 18:e2023065373. Forster CS, et al. Pediatrics.

Pediatrics 105

Pediatrics Fluid Resuscitation Research Hospitals 105