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The ECLS-SHOCK Trial: ECPR in Infarct-Related Cardiogenic Shock

RebelEM

Background: Cardiogenic shock develops in up to 10% of patients with acute myocardial infarction (AMI) and carries a 30 day mortality rate around 50%. bleeding, stroke, limb ischemia, and hemolysis). Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. The evidence for this practice has been sparse until now.

Shock 136
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Glasgow Coma Scale in Children

Pediatric EM Morsels

Borgialli DA, Mahajan P, Hoyle JD Jr, Powell EC, Nadel FM, Tunik MG, Foerster A, Dong L, Miskin M, Dayan PS, Holmes JF, Kuppermann N; Pediatric Emergency Care Applied Research Network (PECARN). Pediatric adjusted reverse shock index multiplied by Glasgow Coma Scale as a prospective predictor for mortality in pediatric trauma.

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There will be a breakthrough in AF ablation coming next week at the ESC meeting

Sensible Medicine

Strokes and heart failure are the main complications of AF. And even when drugs suppress AF, trials failed to show that doing so reduces stroke or heart failure. It was a shocking result. In population studies, AF associates with worse outcomes. Plus, many patients have symptoms from AF. Drugs to suppress AF are not the best.

Stroke 85
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Sniffing out Sepsis - Vibes vs Scoring Systems?

Taming the SRU

National campaigns to improve sepsis care, namely the Centers for Medicare and Medicaid Services’ introduction of “Severe Sepsis and Septic Shock Early Management Bundle”, have faced many challenges in physician and provider adherence. Sepsis as a disease process has been difficult to both clearly define and quickly recognize.

Sepsis 89
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Is a Cuff Enough?

Taming the SRU

Results They studied 1852 patients in the MICU with the most common admission diagnoses being respiratory failure (34 %), sepsis (23 %), and primary CNS disease such as stroke or hemorrhage (23 %). Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med. 2021;49:e1063-e1143.

Sepsis 93
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A Response to the NEJM's Sepsis Review Article

PulmCCM

An excellent review article titled “Sepsis and Septic Shock” was published 4 December 2024 in the New England Journal of Medicine. As for the body of research literature, clinical researchers usually do not have access to superior diagnostic techniques. But it feels like something important was missed, or misplaced.

Sepsis 45
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SGEM#268: Vitamin C Not Ready for Graduation to Routine Use

The Skeptics' Guide to EM

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