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 74

Seizures Fractures EKG/ECG Resuscitation 74

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

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

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 68

Emergency Department Blood Transfusions Resuscitation Sepsis 68

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. Birth History How long was the labour? Postnatal History Ask about respiratory effort since birth.

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

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). Caution with use of NIPPV – positive pressure can worsen injury as well as increase subcutaneous emphysema.

Operations 67

Operations Radiology Radiology Fluid Resuscitation 67

Don't Forget the Bubbles

JULY 5, 2023

SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Vaccination: PCV13 (pneumococcal vaccination), meningococcal vaccines, and Hib conjugated vaccines are important to prevent life-threatening sepsis.

Blood Transfusions 126

Blood Transfusions Stroke Dehydration Sepsis 126

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

Case A female in her 60s presented with 3 days of nausea, vomiting, and diarrhea, and not feeling well. 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. You need to be interested and understand the value of the ECG. Previous ECG.

EKG/ECG 52

EKG/ECG Outcomes Shock Sepsis 52

PEMBlog

MARCH 27, 2024

Or, well, the ringer called me. 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. Now the important thing for EM providers to know is that this can mimic the presentation of sepsis.

Pediatrics 59

Pediatrics Seizures Emergency Department Sepsis 59

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. 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.

Pediatrics 52

Pediatrics Sepsis Shock Outcomes 52

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

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. 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.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Poisoning EKG/ECG Seizures 52

Pediatric Emergency Playbook

MAY 1, 2017

Home care The neonate who is safe to go home is well appearing, and not dehydrated. Make sure to enlist the family's help and support to keep Mom hydrated, eating well, and resting whenever she can. My take away: we now have some evidence basis for using filtered sunlight as an adjunct for babies well enough to go home.

Dehydration 52

Dehydration Pediatrics Wellness Seizures 52

Mind The Bleep

DECEMBER 31, 2023

Damaged kidneys don’t handle drugs well Or fluids! If the patient is an outpatient, they should be called to check they are well. These require swabs, antibiotics, potentially a sepsis screen and bleeping your registrar / consultant for further advice. Be gentle with both. In certain circumstances (e.g.

Fluid Resuscitation 52

Fluid Resuscitation Hospitals Sepsis EKG/ECG 52

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 87

Psychiatric Seizures Emergency Department Pediatrics 87

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 63

Documentation/Coding Seizures Psychiatric Wellness 63

EMDocs

OCTOBER 5, 2024

ESBL are found exclusively in Gram-negative organisms, including: Klebsiella pneumoniae Klebsiella oxytoca Escherichia coli Proteus mirabilis Pseudomonas aeruginosa The first reported beta-lactamase enzyme was reported in 1963, and today there are well over 350 ESBL enzyme variants.

EMS 74

EMS Infectious Diseases Sepsis Hospitals 74

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

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. Previously well child? “ Pregnancy was uncomplicated and he was well after birth. Physical examination: Joey is well-grown.

Wellness 103

Wellness Seizures Hospitals Dehydration 103

Pediatric Education

SEPTEMBER 1, 2024

Smallpox is an ancient disease and an especially well-known cause of severe morbidity and mortality and therefore was used as a curse or epiphet. 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

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 ). It is well-recognised that the environment in the PICU can negatively affect children and their parents/caregivers, increasing the probability of delirium.

Pediatrics 59

Pediatrics Hospitals Sepsis Administration 59