Pediatric EM Morsels

APRIL 5, 2024

(Jensenius 2004) Treatment : doxycycline Human granulocytic anaplasmosis Causative Agent: Anaplasma phagocytophilum , a rickettsial bacteria (Sanchez 2016) Previously seen in the endemic regions of North America where lyme is common, it is now being seen more frequently in travelers to Europe and eastern Asia as well. Ogden, and P.J.

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CDC Infectious Diseases Pediatrics Wellness 161

Taming the SRU

APRIL 17, 2024

IABP MAP measurements tended to have a lower diastolic blood pressure measurement, which caused much of the discrepancy between NIBP and IABP measurement, although the clinical significance of this is not well understood.(4) Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.

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Sepsis Research Stroke Academics 93

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. Jeff : So as well all know Sepsis is bread and butter emergency medicine, but, what is sepsis? Optimal management of septic patients has been a source of intense research, stemming from the landmark study by Rivers in 2001.

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Sepsis Shock Fluid Resuscitation Hospitals 40

RebelEM

AUGUST 14, 2023

in both groups Mean APACHE II score was 12 in both groups Almost half of the patients had septic shock at enrollment Mean time from sepsis identification to randomization was 1.4 Investigators asked a patient-centered research question. Many of the secondary outcomes were changed well after most of the data was acquired.

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Sepsis Outcomes Administration EMS 96

Sensible Medicine

AUGUST 20, 2023

His most recent Circulation paper: Bringing the Credibility Revolution to Observational Research in Cardiology. One of the main lessons is that no matter how well the authors avoid causal language, the intent of an observational comparison study is causal. Here is the profile for Harvard Professor Robert (Bobby) Yeh.

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Shock Research Wellness 52

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. It’s a wonderful contribution to the literature and well worth reading. These are nonfalsifiable claims that illustrate the problem well.

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Sepsis Shock Research Wellness 45

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).

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Sepsis Shock Outcomes Stroke 52

AED Leader

APRIL 21, 2024

An AED is a portable device that delivers an electric shock to the heart to restore its normal rhythm. Research AED Brands : Visit our website, AED Leader, to explore the wide range of AED brands and models available. Remember, investing in an AED is investing in the safety and well-being of those around you.

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Shock CPR Research Wellness 52

Don't Forget the Bubbles

OCTOBER 10, 2024

The others, such as respiratory rate, heart rate, and decompensated shock, were excluded due to the presumed difficulty for non-healthcare professionals to assess them accurately. Adopting this approach would reduce time in surgery for the child as well as the financial cost of nail bed repair. 61 out of 77 departments responded.

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Emergency Department Outcomes Research Operations 75

Stop and Think

JUNE 13, 2023

It’s shocking how many have subscribed and supported this newsletter. He says it is cynical and if I say a study was done for marketing it might insult the researchers. Well, the authors of the smaller trial did not choose clinical outcomes, such as heart failure or death, as the primary endpoint.

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Outcomes Academics Shock Hospitals 98

Sensible Medicine

AUGUST 14, 2024

In popular (lay) understanding, SIDS represents a common danger that a well-cared for and apparently healthy baby will suddenly and terrifyingly be found dead in the morning. Researchers comb through the victims’ genomes for mutations in cardiorespiratory function and autonomic arousal systems. Dr. Paul N.

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CDC Sepsis Research Pediatrics 95

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. [display_podcast] Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Probably not.

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Sepsis Emergency Department Seizures Pediatrics 52

AED Leader

SEPTEMBER 28, 2024

Key takeaways AEDs, like the Philips HeartStart OnSite and ZOLL AED Plus, help save lives during sudden cardiac arrest by checking the heart’s rhythm and delivering a shock if needed. Models designed for home or public spaces have different features like durability and automatic shocks. They are easy for anyone to use.

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CPR Shock Pediatrics Operations 52

Don't Forget the Bubbles

JULY 26, 2023

A cardiac family history should of course be sought, but think a little outside the box as well. For anyone approaching a structured ABC would be a priority to establish whether shock was present or not. We now have a patient who is in sustained SVT but with no features of shock. Family history. What if this does not work?

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EKG/ECG Hospitals Shock Documentation/Coding 98

Greater Sydney Area HEMS

APRIL 26, 2023

Both the stuff of legend and go by multiple names including harness hang syndrome and orthostatic intolerance, as well as bigfoot and the abominable snowman, respectively. Thus, ST management has been heavily based on lay opinion, and until recently, lightly on peer-reviewed research. Health and Safety Executive Research Report 451.

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Hyperthermia / Hypothermia Shock Research Operations 52

RebelEM

JANUARY 25, 2024

CHF, in particular, lends itself well to diagnosis and treatment with PoCUS, as it readily reveals the presence of B lines. POCUS in dyspnea, nontraumatic hypotension, and shock; a systematic review of existing evidence. Furthermore, the serial US group included more patients with conditions detectable with US. vs. 18.3%).

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Ultrasounds Outcomes COPD Hospitals 122

Don't Forget the Bubbles

NOVEMBER 15, 2023

She had septic shock on presentation and was resuscitated with 60ml/kg of balanced crystalloid solution and escalating vasoactive medications. As well as considering volume, hyponatraemia is a harmful consequence of incorrect administration of fluids. Remember, we can add more if needed, but taking it away is much harder.

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Resuscitation Dehydration Administration Shock 80

AED Leader

SEPTEMBER 24, 2024

Key takeaways Automated External Defibrillators (AEDs) increase survival rates by detecting irregular heart rhythms and delivering shocks during cardiac arrest. They analyze heart rhythms and provide shocks if needed to restore a normal heartbeat. It features a pediatric mode, enabling safe treatment for children as well.

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Pediatrics Shock Operations Wellness 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. Fujii et al ( VITAMINS RCT) JAMA 2020: n=216 patients with septic shock. You can listen to his introduction at this LINK.

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Sepsis Shock Outcomes Research 40

AED Leader

SEPTEMBER 21, 2024

Why is defibrillation important Defibrillation is the process of delivering an electrical shock to a person experiencing life-threatening heart rhythms, like ventricular fibrillation (VF) or pulseless ventricular tachycardia. The defibrillator administers a shock measured in joules to the heart at precisely the right moment.

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CPR Shock Resuscitation Hospitals 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? Groups were well matched at baseline. N Engl J Med.

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Blood Transfusions Research Outcomes Hospitals 78

The Skeptics' Guide to EM

NOVEMBER 12, 2022

Salim is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that try to cut down knowledge translation gaps of research to bedside clinical practice. Case: A 38-year-old male presents to the emergency department (ED) with acute mid epigastric abdominal pain with nausea and vomiting.

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Fluid Resuscitation Resuscitation Emergency Department Shock 52

ACEP Now

SEPTEMBER 13, 2023

Emergency Medicine research was and still is tremendously underfunded,” says John E. We wanted to reach emergency physicians, nurses and others working in trauma as well as those at Health and Human Services and the Centers for Disease Control. Prescott, MD, another member of the committee. “We

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EMS Research Military Academics 45

PulmCCM

JANUARY 2, 2025

Previous researchers testing antibiotic durations and procalcitonin use specified even higher noninferiority margins of 10%, so 5.4% The ADAPT-Sepsis Trial Between 2018 and 2024 at 41 centers in the U.K., is a significant improvement. Procalcitonin-guided strategies are already considered safe in evidence assessments by U.K.

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Sepsis Outcomes Stroke Shock 98

Pediatric Emergency Playbook

APRIL 1, 2016

Brain natriuretic peptide (BNP) In adults, we typically think of a BNP Luckily, we have data in children with congenital heart disease as well. This has been studied in children as well, and an elevated lactate in children – typically above 4 – was a predictor of prolonged ICU course and mortality in septic patients.

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Pediatrics Sepsis Shock Outcomes 52

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 76

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).

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Sepsis Shock Hospitals Infectious Diseases 52

PHEM Cast

JULY 14, 2016

Value of a rigid collar: in need of more research and better devices. Crane T, Cooke MW, Wellings R, Wayte S, Higgins J. Journal of Emergencies, Trauma, and Shock. : A systematic review. Elsevier Ltd; 2015 Apr 1;46(4):528–35. Smyth M, Cooke MW. Emergency Medicine Journal. 2013 May 13;30(6):516–6. The University of Warwick.

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Fractures Hospitals Shock Research 52

PEMBlog

JUNE 5, 2024

It was inspired by a hot-off-the-presses publication from the Pediatric Emergency Care Applied Research Network (PECARN) focused on clinical decision rules for cervical spine imaging in children. Leonard JR, Jaffe DM, Kuppermann N, Olsen CS, Leonard JC; Pediatric Emergency Care Applied Research Network (PECARN) Cervical Spine Study Group.

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Fractures Pediatrics Radiology Radiology 52

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. Intervention: Three-day course of oral prednisolone (1mg/kg once daily).

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Emergency Department Pediatrics Sepsis Hospitals 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. Indeed, a recent consensus statement suggested a fluid challenge be 500 mL infused in less than 30 minutes. ED50] and in 90% [i.e.,

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Wellness Outcomes Sepsis Stroke 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. This referral procedure is only possible with a well-structured system and may not be feasible in all settings. Wyrwa JM, et al. Pediatrics. Deng J, et al.

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Pediatrics Hyperthermia / Hypothermia Emergency Department Urgent Care 52

Advanced Emergency Nursing from AENJ

MAY 3, 2014

Although told several times, the story of the development by Henning Ruben of the prototypical modern manual resuscitator, the self-refilling bag with unidirectional non-rebreathing valves which now dominate the world of resuscitation, is still not well-known. National Research Council (US). Committee on Shock. Health Devices.

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Resuscitation Military Operations Emergency Nursing 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

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Poisoning Hyperthermia / Hypothermia Seizures Emergency Department 52

Advanced Emergency Nursing from AENJ

JANUARY 26, 2015

All went well. Journal of Emergencies, Trauma and Shock, 3(1), 39. Journal of clinical and diagnostic research: JCDR, 8(10), FC05. Not in the textbook, but it worked. Usually, in the ED, the simple and great goal is to get the parturient upstairs to OB-GYN, if you have one, as soon as possible. Capriola, M. Emergency, 129, 80-1.

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OB/GYN Ultrasounds Emergency Department Resuscitation 40

Downeast Emergency Medicine

APRIL 26, 2021

When looking at the subgroups with severe shock, there was an 18.5% When stratifying TXA administration time after injury and qualifying shock incidence, there appeared to be a lower 30 d mortality if TXA was given within 1 hour of the incident. Global neurotrauma research challenges and opportunities. MI or stroke).

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Head Injuries Administration Outcomes Seizures 52

Pediatric EM Morsels

JULY 21, 2023

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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Head Injuries Pediatrics Outcomes Shock 246