EM Curious

JULY 8, 2015

ULTRASOUND GOODIE BAG ULTRASOUND FOR LATE PREGNANCY [PODCAST]: While not a routine exam we perform other than confirming fetal heart tones, definitely some great pearls on more advanced US topic. Consider an ultrasound guided ulnar nerve block. Part 1 here. US GUIDED ULNAR NERVE BLOCK [BLOG]: Boxer's fracture need a reduction?

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

Dr. Smith's ECG Blog

OCTOBER 26, 2010

More often, tachycardia with ST segment abnormalities (elevation or depression) is due to an underlying illness (PE, sepsis, hemorrhage, dehydration, hypoxia, respiratory failure, etc.). Large volume fluid resuscitation was undertaken. The patient was suffering from severe dehydration, possibly with sepsis. The K returned at 6.9

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

Taming the SRU

MAY 5, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. N Engl J Med. 2023;388(6):499-510. 2018, Kuttab, Lykins et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

PulmCCM

MARCH 1, 2022

The core of the conference is, no doubt, ultrasound, especially because Philippe has been at the forefront of point of care ultrasound in the intensive care unit. Therefore, there will be much ultrasound learning during hands-on workshops, in addition to the large library of digital offerings to supplement the face-to-face component.

Ultrasounds 40

Ultrasounds Resuscitation Sepsis 40

Critical Care Now

APRIL 26, 2022

His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. They quickly recognized the underlying condition and began resuscitation and stabilization before transport. Reading Time: 3 minutes Mohamed Hagahmed, MD, EMT-P Mohamed is an Emergency Medicine Physician and EMS director.

Resuscitation 52

Resuscitation Fluid Resuscitation EMS Sepsis 52

Emergency Medicine Ireland

JANUARY 22, 2024

It’s clear that the features listed above are fairly non specific and like always it’s likely just sepsis. Firstly do a bit of resuscitation. There may well be some co existing sepsis so give some antibiotics. Our first relevant condition is the wonderfully named thyroid storm.

Sepsis 52

Sepsis Resuscitation Wellness Administration 52

EMDocs

OCTOBER 8, 2024

The full differential diagnosis of sinus tachycardia in isolation is extensive ranging from benign etiologies such as anxiety to severely life threatening etiologies such as sepsis. Additional resuscitation Have we addressed all potential sources of shock for the patient in front of us? Axilla, Sacral, GU Overall Volume Status?

Shock 105

Shock Emergency Department Pediatrics EKG/ECG 105

Pediatric Emergency Playbook

AUGUST 1, 2017

Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. Pyloric Stenosis Aspelund G, Langer JC. Current management of hypertrophic pyloric stenosis. Semin Pedaitr Surg. 2007; 16:27-33. Dias SC et al. Insights Imaging. 2012; 3:247-250. Kawahara H et al. J Pediatr Surg. 2005; 40:1848-1851.

Pediatrics 52

Pediatrics Ultrasounds Resuscitation Sepsis 52

RebelEM

JANUARY 25, 2023

2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 2.3 – 5.4) (-) LR: 0.18 (0.09 – 0.35) Ultrasound Findings Dilated loops of bowel (diameter > 2.5 Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43

Operations 52

Operations Sepsis Resuscitation Ultrasounds 52

The Skeptics' Guide to EM

JANUARY 25, 2020

His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Case: A 60-year-old male is in your emergency department with sepsis from pneumonia.

EMS 40

EMS Airway Management Administration Resuscitation 40

Northwestern EM Blog

FEBRUARY 14, 2022

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. Two classes of vasopressors have been used in the past for hypotension. They are catecholamines and vasopressin-like peptides.

Shock 52

Shock Resuscitation Fluid Resuscitation Sepsis 52

Pediatric Emergency Playbook

JUNE 1, 2016

Cardiogenic Shock: Act Use point-of-care cardiac ultrasound : Good Squeeze? It’s seen easily enough on point of care ultrasound. Tamponade: if any sign of shock, pericardiocentesis, preferentially ultrasound-guided. Children with sepsis come in two varieties: warm shock and cold shock. Pericardial Effusion?

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Don't Forget the Bubbles

MAY 8, 2024

Use of neonatal lung ultrasound in European neonatal units: a survey by the European Society of Paediatric Research. 2024 Apr 3:114037 Apnea, Intermittent Hypoxemia, and Bradycardia Events Predict Late-Onset Sepsis in Infants Born Extremely Preterm. Shah M, et al. 2024 Apr 12:114054. Alonso-Ojembarrena A, et al. Marinelli T, et al.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Was there any prenatal care or ultrasound done? Check a glucose ad drug screen Sepsis - Saved for last - You'll almost always treat the sick neonate empirically for sepsis - think of congenital and acquired etiologies. Before you decide on sepsis, ask yourself, could this be a cardiac problem?* ACEP/McGraw-Hill, 2013.

Seizures 40

Seizures Sepsis Pediatrics Shock 40

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. Nachi: Diagnosis of appendicitis, in a pregnant patient, ultrasound vs. mri. was sensitive for 28-day mortality in sepsis. Jeff: Indeed. Sounds familiar. Jeff: We sure did!

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

Dr. Smith's ECG Blog

MAY 19, 2020

The ways to tell for certain include intravascular ultrasound (to look for extra-luminal plaque with rupture) or "optical coherence tomography," something I am entirely unfamiliar with. pulmonary embolism, sepsis, etc.), The diagnosis of MINOCA should exclude: 1) other overt causes for elevated troponin (e.g., myocarditis).

CPR 52

CPR EKG/ECG Shock Ultrasounds 52

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

EB Medicine

NOVEMBER 1, 2018

Thankfully, that gentleman was successfully resuscitated despite no bystander CPR, and if you listen carefully, we hope to arm you with the tools to do so similarly. Jeff: And unlike past issues covering more common pathologies, like, say, sepsis, this month’s team reviewed much more literature than just the past 10 years.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.

EKG/ECG 40

EKG/ECG Shock Fluid Resuscitation Documentation/Coding 40

Mind The Bleep

DECEMBER 31, 2023

Again, ask your registrar or consultant if you are unsure about fluid resuscitation/balance/maintenance in renal patients. These require swabs, antibiotics, potentially a sepsis screen and bleeping your registrar / consultant for further advice. Always run renal drug dosing by a pharmacist if you are unsure.

Fluid Resuscitation 52

Fluid Resuscitation Hospitals Sepsis EKG/ECG 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

Widespread ST-depression with reciprocal aVR ST-elevation can be cause by: Heart rate related: tachyarrhythmia (e.g., This finding does not alter the need to pursue emergent reperfusion, although it might suggest a poorer prognosis.”[3] Knotts RJ, Wilson JM, Kim E, Huang HD, Birnbaum Y.

EKG/ECG 52

EKG/ECG Shock Sepsis Emergency Department 52

EMDocs

DECEMBER 18, 2023

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. 3,4 Prompt recognition and management of sepsis and septic shock are paramount for the ED clinician. vs. 0.91), positive predictive value (0.27

Sepsis 91

Sepsis Fluid Resuscitation Resuscitation Shock 91

EB Medicine

SEPTEMBER 1, 2018

If EMS has placed bandages, leave them in place until antivenom and resuscitative equipment is ready. Jeff: I feel like we should get some entry music for every ultrasound reference because it seems to make its way into just about every episode. It’s an easy number to remember. 1-800-222-1222. Lavonas EJ, Ruha AM, Banner W, et al.

Emergency Department 40

Emergency Department Poisoning Anaphylaxis Allergic Reactions 40

Don't Forget the Bubbles

NOVEMBER 1, 2023

This is not always feasible in an acute resuscitation scenario. This retrospective observational cohort study looked at whether lactate can be used to predict the need for acute resuscitation in paediatric emergency department (PED) patients. In children who did not need acute resuscitation, the 95th percentile of lactate was 3.2

Emergency Department 140

Emergency Department Hospitals Resuscitation Administration 140

Don't Forget the Bubbles

FEBRUARY 5, 2024

Role of diagnostic tests for sepsis in children: a review. Sustained inflation and chest compression versus 3:1 chest compression to ventilation ratio during cardiopulmonary resuscitation of asphyxiated newborns (SURV1VE): A cluster randomised controlled trial. Anagnostou A, et al. Arch Dis Child. 2024 Jan 12:archdischild-2023-326225.

Pediatrics 52

Pediatrics Research Resuscitation Psychiatric 52

Taming the SRU

AUGUST 25, 2023

bicarb <18mEq/L) ketosis (preferably serum beta-hydroxybutyrate >3mmol/L) Risk factors SGLT2 inhibitor use fasting state ketogenic diet intra-abdominal pathology (AGE, pancreatitis, etc.)

Seizures 75

Seizures Fractures EKG/ECG Resuscitation 75

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. In lower-resource settings, the evidence is stronger against a liberal approach to volume resuscitation.

Dehydration 75

Dehydration Fluid Resuscitation Sepsis Resuscitation 75

EMDocs

OCTOBER 29, 2024

Critical Care Ultrasound in Shock: A Comprehensive Review of Ultrasound Protocol for Hemodynamic Assessment in the Intensive Care Unit. Conventional cardiopulmonary resuscitation-induced refractory cardiac arrest due to latent left ventricular outflow tract obstruction due to a sigmoid septum: a case report. J Thorac Dis.

Shock 98

Shock EMS Sepsis Resuscitation 98

Dr. Smith's ECG Blog

DECEMBER 23, 2024

She was resuscitated and admitted to ICU for presumed sepsis. If you do not have an arterial line, use bedside ultrasound to verify myocardial contractility corresponds to pacing. If you don't have ultrasound (but you should), then palpate a pulse! Her family had not heard from her and called EMS.

EKG/ECG 114

EKG/ECG Shock Ultrasounds Sepsis 114

Don't Forget the Bubbles

FEBRUARY 17, 2025

He has received 20ml/kg in 5 to 10ml/kg aliquots in the ED, as his blood pressure keeps dropping, and the ED team is concerned about possible sepsis. He has had some additional episodes of hypotension post-intubation, which is treated with further volume resuscitation. As the PICU Registrar, you are called to review him.

Pediatrics 78

Pediatrics Ultrasounds Shock Resuscitation 78

Broome Docs

JANUARY 27, 2025

Diagnosis of acute aortic syndromes with ultrasound and D-dimer: the PROFUNDUS study. Biomarker-Guided Antibiotic Duration for Hospitalized Patients With Suspected Sepsis: The ADAPT-Sepsis Randomized Clinical Trial. PMID: 39383344 Profundus Trial – Can we actually exclude acute aortic syndromes with this protocol?

Sepsis 101

Sepsis Anaphylaxis Hospitals Ultrasounds 101