Taming the SRU

JULY 24, 2024

Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med 2024 Background Sepsis remains an increasingly common emergency department condition that is tied to higher morbidity and mortality across the United States as well as the rest of the world.

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Sepsis Resuscitation Emergency Department Wellness 89

EMDocs

JANUARY 11, 2025

2, 8-10, 14 The clinical symptoms range from vague abdominal pain to florid septic shock and peritonitis secondary to bowel perforation. Clinical exam: 2, 3, 9 Abdominal distension and tenderness Nausea and vomiting Stool present in the rectal vault Peritonitis may be accompanied by hemodynamic instability in the case of sepsis.

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EMS Sepsis Shock Fluid Resuscitation 98

RebelEM

AUGUST 14, 2023

Background: Could Xuebijing (XBJ) catalyze a paradigm shift in sepsis management? XBJ is an herbal compound used in China to manage various inflammatory and infectious processes in recent years, including sepsis. This post evaluates the recent “Efficacy of Xuebijing Injection in Patients With Sepsis (EXIT-SEP)” trial.

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Sepsis Outcomes Administration EMS 98

Taming the SRU

DECEMBER 17, 2024

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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Dehydration Fluid Resuscitation Resuscitation Administration 84

EMDocs

MAY 31, 2023

The post Visual Wednesdays: Septic Shock Management appeared first on emDOCs.net - Emergency Medicine Education. Author: Walid Malki, MD ( @Wandering_ER ) // Reviewed by: Brit Long, MD (@long_brit); Alex Koyfman, MD (@EMHighAK) Welcome the Visual Wednesdays, a series that provides focused EM updates with infographics.

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Shock EMS Sepsis 98

EMDocs

APRIL 6, 2024

. #1: Phoenix Criteria – New Pediatric Sepsis Score Spoon Feed The Phoenix Sepsis Score, which is a novel clinical criterion for pediatric sepsis and septic shock developed using measures of organ dysfunction, outperforms existing IPSCC criteria for the diagnosis of pediatric sepsis and septic shock.

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Sepsis Pediatrics Shock 97

FOAMCast Blog

FEBRUARY 21, 2016

(ITUNES OR LISTEN HERE) The Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) redefined sepsis with the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Septic shock is a subset of sepsis where underlying circulatory and […]

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Sepsis Shock 52

EB Medicine

JANUARY 3, 2023

In this episode, Sam Ashoo, MD, interviews Ara Festekjian, MD, one of the authors of the November 2022 Pediatric Emergency Medicine Practice article on Pediatric Septic Shock in the Emergency Department Introduction: How common is sepsis in kids and what is the mortality rate in the US?

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Shock Pediatrics Airway Management Sepsis 52

PulmCCM

NOVEMBER 1, 2024

Neither of two large randomized trials in the 2000s showed a benefit from albumin solutions as a resuscitation fluid for patients with septic shock. Significant uncertainty remained, though, as we discussed further here: Another randomized trial was therefore performed, dubbed ABC-SEPSIS.

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Sepsis Shock Resuscitation 40

PHEM Cast

APRIL 10, 2016

[link] We hope you enjoyed our sepsis podcast. St Emlyns Induction podcast on Sepsis. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. A great summary of what to do when a patient with suspected sepsis first arrives in the ED. March 2016.

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Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

Taming the SRU

MARCH 30, 2023

Diastolic shock index and clinical outcomes in patients with septic shock. O: There was an association between increased diastolic shock index score and mortality at 90 days and performed similarly to more advanced measures of morbidity and mortality in septic shock including lactate levels and SOFA scores.

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Shock Outcomes Sepsis Resuscitation 52

Emergency Medicine Cases

MARCH 26, 2019

Sara Gray, intensivist and emergency physician, co-author of The CAEP Sepsis Guidelines, answers questions such as: How does one best recognize occult septic shock? Which fluid and how much fluid is best for resuscitation of the septic shock patients? What are the indications for a second vasopressor after norepinephrine?

Sepsis 40

Sepsis Shock EMS Resuscitation 40

EMDocs

AUGUST 17, 2023

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,

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Sepsis Shock Resuscitation Fluid Resuscitation 93

EMDocs

SEPTEMBER 6, 2023

Learning points: Consider differential – sepsis, thyroid storm, thalamic stroke, exertional and classic heat stroke, serotonin syndrome, neuroleptic malignant syndrome, sympathomimetic toxicity, and anticholinergics. Shock types: distributive, cardiogenic, obstructive, metabolic, hypovolemic, adrenal. Am J Emerg Med.

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Anaphylaxis Shock Sepsis Stroke 96

Board Bombs

APRIL 30, 2023

Lets talk about a lesser common cause of shock. Cardiogenic Shock. Lets talk about a lesser common cause of shock. Cardiogenic Shock. In fact, it might just decide to kill the patient if you do that. Want to experience the greatest in board studying? Cite this podcast as: Briggs, Blake; Husain, Iltifat. Episode 174.

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Shock Sepsis 52

Board Bombs

APRIL 30, 2023

Let’s talk about a lesser common cause of shock. Cardiogenic Shock. Let’s talk about a lesser common cause of shock. Cardiogenic Shock. In fact, it might just decide to kill the patient if you do that. Want to experience the greatest in board studying? Cite this podcast as: Briggs, Blake; Husain, Iltifat. Episode 174.

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Shock Sepsis 52

Pediatric EM Morsels

MARCH 29, 2024

If the patient presents in metabolic crisis and the exact diagnosis is not known, ED providers can send additional labs to help expedite the work up by obtaining : Plasma amino acids, Acylcarnitine profile, and Urine organic acids Management Goal: we want to stop the metabolic crisis and convert anabolism Remember your ABCs and O MI Sugar for your (..)

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Dehydration Pediatrics Sepsis EMS 297

Emergency Medicine Cases

SEPTEMBER 12, 2023

The post EM Quick Hits 51 – Methylene Blue in Septic Shock, TMJ Dislocation, Crohn’s Disease, Analgesia for Renal Colic, Inhaled Steroids for Asthma, Hypocalcemia in Bleeding Trauma Patients appeared first on Emergency Medicine Cases.

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Dislocations Shock EMS Sepsis 91

EMDocs

MARCH 4, 2025

Bacterial Meningitis Mimics: Other flu-like illnesses: COVID, influenza, toxic shock syndrome, myocarditis, endocarditis, spinal epidural abscess, pneumonia. A 2020 Cochrane review found the pooled sensitivity was 65%. Do not rely on this to rule out bacterial meningitis. Clin Infect Dis. 2004;39(9):1267-1284. PMID: 15494903 McGill F, et al.

Infectious Diseases 82

Infectious Diseases Seizures Poisoning Sepsis 82

PulmCCM

DECEMBER 11, 2023

Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid bolus) led to similar outcomes as the usual practice of bolusing large volumes of fluids first. Either approach in severe sepsis with shock seems reasonable.

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Sepsis Stroke Shock Infectious Diseases 94

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. health system require us to enter a diagnosis to generate payment by a health insurer, it’s worth emphasizing that sepsis is a syndrome, not a disease.

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Sepsis Shock Research Wellness 45

Taming the SRU

AUGUST 11, 2024

ABEM updates - R4 Capstone - Sepsis Operations update - R3 taming the sru - traveler’s diarrhea abem updates WITH dr. melissa platt, abem board of directors Beginning 2026, ABEM will be requiring a new certifying exam to replace the previous oral boards.

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Sepsis Burns Shock Operations 89

The Skeptics' Guide to EM

NOVEMBER 4, 2023

Time for paediatrics to screen out sepsis “screening.” He specializes in Paediatric Emergency Medicine and is a passionate […] The post SGEM Xtra: Say What You Need to Say…but Don’t Say “Sepsis Screening” first appeared on The Skeptics Guide to Emergency Medicine. Time for paediatrics to screen out sepsis “screening.”

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Sepsis Shock Hospitals 55

RebelEM

FEBRUARY 19, 2024

Background: Use of vasopressors is a common practice to support hemodynamics and optimization of tissue perfusion in patients presenting with shock. The 2021 Surviving Sepsis Campaign Guidelines suggest starting vasopressors peripherally rather than delaying infusion until a CVC is placed [2]. References: Yerke JR et al. CHEST 2024.

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Administration Sepsis EMS Shock 137

EB Medicine

OCTOBER 1, 2018

This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. We have a special episode for you this month… We’ve brought Dr. Jeremy Rose, one of the peer reviewers, and a sepsis expert, on with us to talk through the content this month. Jeff : Sepsis chair. Sepsis-3!!

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Sepsis Shock Fluid Resuscitation Hospitals 40

EMDocs

AUGUST 24, 2023

PICO Population Inclusion criteria Age ≥ 18 years old Patients with septic shock Must have 2/4 SIRS criteria plus Confirmed or suspected source plus Lactate ≥ 4mmo/L or systolic blood pressure ≤ 90 mmHg Had blood cultures completed before antibiotics and were available for collection of an additional set of antibiotics following antibiotics.

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Administration Sepsis Shock Emergency Department 95

The Bottom Line

OCTOBER 28, 2023

Landiolol and Organ Failure in Patients With Septic Shock Whitehouse. 2023.20134 Clinical Question In patients with tachycardia and septic shock who are treated with high dose norepinephrine does the use of β-blockade for up to 14 days reduce organ failure compared to standard care? JAMA Published online October 25, 2023.

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Shock Sepsis 65

University of Maryland Department of Emergency Med

JANUARY 23, 2023

An Uncommon Cause of Shock Sepsis is the most common cause of distributive shock encountered in the emergency department and intens. Click to view the rest

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Shock Sepsis Emergency Department 40

Ken Grauer, MD

FEBRUARY 28, 2023

These 2 settings are: i ) In patients with severe , often longstanding pulmonary disease ; and / or , ii ) In acutely ill patients with multi-system disease ( ie, sepsis, shock, electrolyte and/or acid-base disorders ). MAT almost always occurs in one of 2 common predisposing settings.

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EKG/ECG Documentation/Coding Sepsis COPD 195

Dr. Smith's ECG Blog

OCTOBER 20, 2024

sepsis, anemia, hypoxemia, severe hypotension etc., Figure B At this point, with the ECG changing from diffuse ST depression to widespread ST elevation and the patient presenting in cardiogenic shock, left main coronary artery (LMCA) occlusion is the likely diagnosis. Suspect LMCA with sudden shock and widespread ST elevations.

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EKG/ECG Shock Emergency Department Ambulance Services 128

EMDocs

JANUARY 23, 2024

Episode 93: BRASH syndrome Background: Brash syndrome has 5 components: bradycardia, renal failure, AV nodal blocker, shock, hyperkalemia. An inciting event will typically push them over the edge into BRASH syndrome: Dehydration Hypotension from sepsis or another condition GI illness Dosage increase of a chronic medication (e.g.,

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Shock Dehydration Sepsis EKG/ECG 113

Pediatric Emergency Playbook

JUNE 1, 2016

Do we recognize shock early enough? World wide, shock is a leading cause of morbidity and mortality in children, mostly for failure to recognize or to treat adequately. So, what is shock? Simply put, shock is the inadequate delivery of oxygen to your tissues. How do we prioritize our interventions? Pericardial Effusion?

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Shock Sepsis Pediatrics Ultrasounds 40

Sensible Medicine

APRIL 15, 2024

A common cause of cardiogenic shock occurs when a blocked coronary artery (myocardial infarction or MI) causes the heart to fail. Cardiogenic shock from MI has a death rate of about 50%. This is why the DanGer-Shock trial had to be done in Denmark, a place where doctors are perhaps a little less sure of themselves. It did not.

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Shock Sepsis Hospitals 89

Emergency Medicine Journal

NOVEMBER 28, 2023

Aims and Objectives In 2021, the Surviving Sepsis Campaign International Guidelines advised clinicians to administer antimicrobials within 1h and 3h to sepsis patients with and without shock respectively. We aim to evaluate whether the timing of antibiotic administration in admitted sepsis patients affects mortality.

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Sepsis Administration Shock 40

EMCrit

MARCH 10, 2023

CLOVERS Trial Primer and Fluids in Septic Shock EMCrit Project by Scott Weingart, MD FCCM.

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Sepsis Shock 73

Taming the SRU

APRIL 17, 2024

The surviving sepsis guidelines weakly recommend invasive arterial blood pressure monitoring (IABP) over noninvasive blood pressure monitoring (NIBP) with a blood pressure cuff supported by low quality evidence.(1) Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.

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Sepsis Research Stroke Academics 94

JournalFeed

DECEMBER 2, 2023

Friday Spoon Feed: A randomized trial of patients in septic shock on norepinephrine found no benefit in those treated with an infusion of landiolol (β1-blocker). Tuesday Spoon Feed: This RCT found no differences between high dose (16 mg) and low dose (4 mg) IV dexamethasone in patients who presented to EDs with migraine headaches.

Sepsis 52

Sepsis Shock 52