Remove Seizures Remove Sepsis Remove Shock
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But Can You Just PO?

Taming the SRU

There is substantial evidence that IV fluids can be beneficial in patients with sepsis complicated by hypotension and labor. Other contraindications include those who are unable to drink liquid (respiratory problems or impaired unconsciousness) and patients in shock, persistent vomiting, or with an ileus.

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emDOCs Podcast – Episode 115: Adult Meningitis

EMDocs

Neurologic deficits, seizures, cognitive issues, hearing loss. Bacterial Meningitis Mimics: Other flu-like illnesses: COVID, influenza, toxic shock syndrome, myocarditis, endocarditis, spinal epidural abscess, pneumonia. Associated with a variety of causes, but a bacterial infection is one of the more dangerous ones. Clin Infect Dis.

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52 in 52 – #41: The CENSER Trial

EMDocs

mL/kg/hr for 2 consecutive hours OR Decrease in serum lactate by more than 10% from initial level Primary outcome – Early norepinephrine group vs. the control group demonstrated higher rates of shock control at 6 hours: 76.1% vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, vs 48.4% (OR 3.4,

Sepsis 86
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Grand Rounds Recap 1.10.24

Taming the SRU

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 (..)

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SGEM#195: Some Like It Hot – ED Temperature and ICU Survival

The Skeptics' Guide to EM

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
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emDOCs Revamp: Esophageal Perforation

EMDocs

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.).

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The ECG told the whole story, but no one listened: ECG interpretation skills are critical to patient outcomes.

Dr. Smith's ECG Blog

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 the notes mention "cardiogenic shock" but without any reference to a cardiac echo or to a chest x-ray. This is the etiology of the syncope and hypotension and shock and elevated CVP.

EKG/ECG 52