Taming the SRU

FEBRUARY 5, 2024

The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. As may be seen in the table below, there are several themes as well a range of stringency. C., & Solomon, T. The Journal of infection , 72 (4), 405–438. van de Beek, D., Cabellos, C.,

Infectious Diseases 98

Infectious Diseases Seizures Ultrasounds Sepsis 98

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

EMDocs

NOVEMBER 1, 2023

1 , 2 The most common non-iatrogenic cause is spontaneously due to increased intraesophageal pressure, Boerhaave syndrome, from forceful retching, coughing, straining, seizures, or even childbirth (15% of cases). upper endoscopy, transesophageal echo, etc.). upper endoscopy, transesophageal echo, etc.).

Operations 92

Operations Radiology Radiology Fluid Resuscitation 92

Taming the SRU

JANUARY 12, 2024

Often AE-ILD is idiopathic, but treatable causes must be excluded (PNA, PE, volume overload) Treatment for AE-ILD should include antibiotics for CAP coverage (specifically including azithromycin), steroids, and respiratory support; consider opportunistic infection if immunosuppressed as well as diuresis as needed for euvolemia HFNC should be favored (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

Mind The Bleep

SEPTEMBER 12, 2023

Were there any risk factors for sepsis? Increased work of breathing with grunting and tachypnoea could be due to sepsis, hypoglycaemia or acidosis due to an inborn error of metabolism. Severe jaundice causing kernicterus may also cause central hypotonia and seizures. Birth History How long was the labour?

Sepsis 52

Sepsis Seizures Poisoning Wellness 52

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Definition of status epilepticus:Continuous seizure activity of 5 minutes or greater – OR – Recurrent activity without recovery between intervals. This definition includes clinically apparent seizures as well as those seen only on EEG.) During a seizure, GABA receptors in the neuron’s membrane are internalized and destroyed.

Pediatrics 40

Pediatrics Seizures Stroke Radiology 40

Pediatric Emergency Playbook

MAY 1, 2016

meningoencephalitis, overwhelming alternate source of sepsis) T – Toxins (e.g. sludge phenomenon, secondary sepsis, hypoglycemia from supply-demand mismatch) S – Seizure (e.g. meningoencephalitis, overwhelming alternate source of sepsis) T – Toxins (e.g. V – Vascular (e.g. V – Vascular (e.g. Should you get a CT before LP?

Seizures 40

Seizures Sepsis Stroke Pediatrics 40

Dr. Smith's ECG Blog

JUNE 26, 2023

Most occurrences are associated with events such as sepsis, shock, recent infarction, post-operative state, electrolyte disturbance — or "sick patient". Seizure activity was witnessed at the scene — and head CT scan showed a small bleed. PEARL # 5: Accelerated junctional rhythms are not common in adults.

EKG/ECG 97

EKG/ECG Seizures Sepsis Operations 97

Pediatric Emergency Playbook

SEPTEMBER 1, 2015

Perhaps diGeorge syndrome with hypocalcemia and seizures? Inborn Errors of Metabolism - there are over 200 inborn errors of metabolism, but only four common metabolic pathways that cause a child to be critically ill. Before you decide on sepsis, ask yourself, could this be a cardiac problem?*

Seizures 40

Seizures Sepsis Pediatrics Shock 40

Dr. Smith's ECG Blog

MARCH 30, 2014

They were worried that the syncope was seizure and that she had brain mets. Then they were worried about sepsis as an etiology of hypotension. Then she had some RUQ tenderness which led to a long process of evaluation for an abdominal source of sepsis, which turned up negative. Previous ECG. The lactate was elevated and pH low.

EKG/ECG 52

EKG/ECG Outcomes Shock Sepsis 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. The short answer – yes.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

Emergency Medicine Ireland

DECEMBER 14, 2020

In terms of reasons to sedate someone in the ICU the following would seem a reasonable selection of reasons * as treatment for disease process (eg seizures, alcohol withdrawal) * to facilitate tolerance of ICU therapies (eg ventilation) * to reduce O2 consumption (eg brain injury or sepsis) * use as palliation In terms of assessing sedation I think (..)

Seizures 40

Seizures Sepsis 40

Taming the SRU

APRIL 13, 2023

stent, percutaneous nephrostomy) by urology or IR Hypokalemia evaluate for EKG changes assess for underlying cause and factors that may influence ability to replete (i.e. Vaishnav Hyperthermia: abnormally high body temperature due to thermoregulatory failure Severe hyperthermia: temp greater than 40.5C

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Pediatric Emergency Playbook

MAY 1, 2017

Check the bilirubin in any neonate you are working up for sepsis. Acute bilirubin encephalopathy may progress to an abnormal neurologic exam, seizures, apnea, or coma. The dehydration and neurologic dysfnction from the hyperbilirubinemia may even cause fever. Kernicterus is the final, permanent result of bilirubin encephalpathy.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Mind The Bleep

DECEMBER 31, 2023

These require swabs, antibiotics, potentially a sepsis screen and bleeping your registrar / consultant for further advice. encephalopathy, pericarditis, seizures) *common dialysable toxins include lithium, aspirin, theophylline along with many others. Peritoneal dialysis has a risk of infection (PD peritonitis or exit site infection).

Fluid Resuscitation 52

Fluid Resuscitation Hospitals Sepsis EKG/ECG 52

EMDocs

DECEMBER 18, 2024

fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

Seizures 105

Seizures Hyperthermia / Hypothermia Emergency Department EMS 105

EMDocs

JUNE 22, 2024

Eclampsia (B) is characterized by the onset of seizures in a woman with preeclampsia (hypertension and proteinuria), but it typically does not present with the sudden onset of respiratory distress and profound hypotension described here. . “Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation.”

EMS 111

EMS Resuscitation Seizures Blood Transfusions 111

EMDocs

OCTOBER 5, 2024

8 Workup and Diagnosis Evaluation should be tailored to the patient presentation, but may include studies such as: CBC, CMP, UA, lactate (if concern for sepsis), Cultures (blood, urine, etc.) Imipenem confers highest risk of seizures ESBL-E are often hospital acquired infections and can prolong hospital stay or lead to worse outcomes.

EMS 97

EMS Infectious Diseases Sepsis Hospitals 97

EMDocs

AUGUST 22, 2023

Capnography has several novel uses in other disease states commonly seen in the ED such as trauma, DKA, sepsis and obstructive lung disease. In cardiac arrest, EtCO 2 is dependent on compressions AND the underlying cause. ETCO 2 correlates with blood pressure, lactate, and base excess in critically ill patients.

Emergency Department 93

Emergency Department Blood Transfusions Resuscitation Sepsis 93

PulmCCM

DECEMBER 10, 2023

Cefepime crosses the blood-brain barrier, and dozens of case reports have associated the drug with seizures, encephalopathy, delirium, and coma, with a possibly increased incidence of neurologic adverse effects among patients with renal failure or sepsis.

Seizures 52

Seizures Sepsis Academics Administration 52

PEMBlog

MARCH 27, 2024

They include neurologic dysfunction, which is one of the most common that includes things like developmental delay, regression, AKA loss of developmental milestones, hypotonia, encephalopathy, or seizures. So they’re lethargic, they might vomit, they’re hypotonic, hypothermic, they might have fever or seizures.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

Taming the SRU

MAY 1, 2023

Exertional Hyperthermia Patients with heat stroke will present with Temp > 104, AMS, or seizures. 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

Don't Forget the Bubbles

MAY 15, 2023

Signs and symptoms in this group are often non-specific and can include irritability, hypotonia, lethargy, jitteriness, temperature instability, poor feeding, vomiting, apnoea and seizures. What’s all this fuss about ketones? All of the cases so far have featured ketotic hypoglycaemia.

Wellness 103

Wellness Seizures Hospitals Dehydration 103

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane).

Sepsis 96

Sepsis Fractures Documentation/Coding Administration 96

EMDocs

APRIL 1, 2025

Ultimately theres thrombus formation => obstructs venous drainage which can lead to cranial nerve compression, sepsis, death. Most common issues include vision loss, cranial nerve (CN) palsies, pituitary dysfunction, hemiparesis, facial disfigurement, seizures, cortical vein thrombosis. How common is it? What is the anatomy?

Dehydration 97

Dehydration Sepsis Seizures Resuscitation 97

Taming the SRU

FEBRUARY 3, 2025

These can lead to a wide spectrum of emergent complications including but not limited to cardiac dysrhythmias, seizures, and acute renal failure. This can often become significant enough to precipitate dysrhythmias, seizures, and tetany (20). paclitaxel, doxorubicin, cisplatin) high-risk monoclonal antibody treatments (i.e.

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56

Don't Forget the Bubbles

DECEMBER 9, 2024

Clinical recommendations for pain, sedation, withdrawal, and delirium assessment in critically ill infants and children Pediatric Acute Lung Injury and Sepsis Investigators ( PALISI ). Examples of these are linked below: European Society of Paediatric and Neonatal Intensive Care ( ESPNIC ). Am J Respir Crit Care Med. 2023;207(1):17-28.

Pediatrics 59

Pediatrics Sepsis Hospitals Administration 59

Taming the SRU

JUNE 6, 2023

HAJDU Mild TBI’s & Concussions in the Emergency Department TBI’s are relatively common >3 million TBI’s in the US annually 2.5 million presentation to ED’s throughout the US Usually occur due to falls Also commonly occur due to sports, MVC’s, etc.

Documentation/Coding 65

Documentation/Coding Seizures Psychiatric Wellness 65

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 mg/kg (of 0.1 2x maintenance rate

Psychiatric 90

Psychiatric Seizures Emergency Department Pediatrics 90

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.) to 1 mcg/kg/hour procedural sedation loading dose: 0.5-1 1 mcg/kg over 10 minutes followed by continuous infusion: 0.2

Seizures 76

Seizures Fractures EKG/ECG Resuscitation 76

PulmCCM

OCTOBER 23, 2023

Cefepime crosses the blood-brain barrier, and dozens of case reports have associated the drug with seizures, encephalopathy, delirium, and coma, with a possibly increased incidence of neurologic adverse effects among patients with renal failure or sepsis.

Hospitals 98

Hospitals COPD Emergency Department CDC 98

Don't Forget the Bubbles

JULY 5, 2023

Vaccination: PCV13 (pneumococcal vaccination), meningococcal vaccines, and Hib conjugated vaccines are important to prevent life-threatening sepsis. Sickle cell patients also qualify to receive the annual influenza vaccine, since influenza virus infection predisposes to bacterial pneumonia and sepsis caused by S. Pneumococcal sepsis B.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

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). Infants usually present in a non-specific manner, following an apnoea, cough, cyanosis, or seizure so a high index of suspicion is required in this age group.

Pediatrics 59

Pediatrics Outcomes Blood Transfusions Sepsis 59

Pediatric Education

SEPTEMBER 1, 2024

Complications include death, scarring, skin superinfection, sepsis, encephalitis, meningitis, febrile seizures, and premature birth. The lesions are 7-10 mm in diameter, round, firm, deep-seated and well circumscribed… ” Lesions tend to appear more on the forearms and face than rest of the body.

Infectious Diseases 40

Infectious Diseases Pediatrics Seizures Sepsis 40