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.

Sepsis 98

Sepsis Outcomes Administration EMS 98

Emergency Medicine Journal

MARCH 25, 2025

Association between time to antibiotic and mortality in patients with suspected sepsis in the emergency department: post hoc analysis of the 1-BED randomised clinical trial by Philippon et al 1 Topic: Sepsis Outcome rating: Game changer The importance of early antibiotic administration in sepsis is well recognised, yet the necessity of strict 1-hour (..)

Sepsis 52

Sepsis Emergency Department Administration Outcomes 52

Dr. Smith's ECG Blog

JANUARY 2, 2025

She was managed for sepsis with antibiotics including azithromycin, had hypotension with arterial and central lines placed and pressors. I do not see OMI here and all trops were only minimally elevated, consistent with either chronic injury from cardiomyopathy or with acute injury from sepsis. She was intubated.

EKG/ECG 116

EKG/ECG Sepsis Wellness Documentation/Coding 116

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. Out of 18 patients receiving ORT, 4 failed to respond well and were escalated to IV therapy. Hospitals can purchase ORT packets for use in EDs as well as giving patients the formula to make their own at home.

Dehydration 84

Dehydration Fluid Resuscitation Resuscitation Administration 84

EMDocs

JANUARY 11, 2025

Well keep it short, while you keep that EM brain sharp. 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. May still be passing small amounts of stool and flatus.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 98

Mind The Bleep

FEBRUARY 2, 2025

However, as an F1, you may well know the patient best and therefore you may be best placed to refer the patient. She is otherwise in good health and is responding well to chemotherapy. could it be driven by a much more pressing sepsis ). We think she now needs inotropes and more ventilator support. rate control? ablation?).

Radiology 96

Radiology Radiology Sepsis Documentation/Coding 96

EMDocs

JANUARY 25, 2025

Well keep it short, while you keep that EM brain sharp. PCP Pneumonia, Sepsis) can be discharged with initiation of Antiretroviral Therapy in consultation with Infectious Disease (ID) physician with full ID evaluation outpatient. 10^9/L) Moderate (0.50.9 10^9/L) Severe (< 0.5 10^9/L) Generalized leukopenia (i.e. Medications: 25.6%

EMS 94

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 94

Mount Sinai EM

JULY 27, 2023

Role of the spleen Red pulp: sinusoids filter out larger rigid particles including senescent and/or parasitized red blood cells, as well as unopsonized bacteria. This is specific but not sensitive.

Sepsis 182

Sepsis Wellness Infectious Diseases 182

Board Bombs

OCTOBER 29, 2023

In the Spirit of Halloween let's cover Pediatric Sepsis- the tricks of the trade and how to not miss infections, as well as what to know for the test. Peds Sepsis: Nightmare on Epi Street. Peds Sepsis: Nightmare on Epi Street. Want to experience the greatest in board studying? Cite this podcast as: Briggs, Blake.

Sepsis 52

Sepsis Pediatrics Wellness 52

Board Bombs

OCTOBER 29, 2023

In the Spirit of Halloween let's cover Pediatric Sepsis- the tricks of the trade and how to not miss infections, as well as what to know for the test. Peds Sepsis: Nightmare on Epi Street. Peds Sepsis: Nightmare on Epi Street. Want to experience the greatest in board studying? Cite this podcast as: Briggs, Blake.

Sepsis 52

Sepsis Pediatrics Wellness 52

ACEP Now

OCTOBER 29, 2024

For example, experienced emergency physicians have great clinical gestalt and accuracy to predict sepsis in critically ill patients at just 15 minutes from patient arrival—more so than scoring tools like the qSOFA, MEWs, and even machine-learning trained artificial intelligence models. Thiruganasambandamoorthy V, Kwong K, Wells GA, et al.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. And lastly, it’s actually quite hard to see how well the cardiovascular system is working, and this is one of its measurable features. This works well for a while, but eventually, the heart beats too fast to fill adequately.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

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. It’s a wonderful contribution to the literature and well worth reading. Without valid diagnostic criteria, sepsis studies are prone to imprecise or biased findings.

Sepsis 45

Sepsis Shock Research Wellness 45

Don't Forget the Bubbles

AUGUST 7, 2023

Heart rate (HR) and respiratory rate (RR) are THE major vital signs used in Advanced Paediatric Life Support ( APLS) guidance , sepsis guidelines , and Paediatric Early Warning Scores (e.g., Identify the percentage of children whose heart or respiratory rate would exceed the “severe” cut-off from the UK Sepsis Trust and NICE guidelines.

Sepsis 98

Sepsis Pediatrics Urgent Care Emergency Department 98

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. Remember — 12 leads are better than one!

EKG/ECG 195

EKG/ECG Documentation/Coding Sepsis COPD 195

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

Seizures 105

Seizures Hyperthermia / Hypothermia Emergency Department EMS 105

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. Crit Care Med.

Sepsis 94

Sepsis Research Stroke Academics 94

EMDocs

NOVEMBER 7, 2023

Antibiotics are recommended for those with complicated diverticulitis, as well as surgical specialist consult if necessary (e.g., Included patients had confirmed uncomplicated diverticulitis but no immunosuppression, peritonitis, sepsis. Patients with sepsis and immunocompromise were not included. No evidence of sepsis.

Sepsis 113

Sepsis Best Practices Hospitals Outcomes 113

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!!

Sepsis 40

Sepsis Shock Fluid Resuscitation Hospitals 40

RebelEM

SEPTEMBER 21, 2023

Troponins are highly specific to cardiac myocytes but do exist in other muscle types as well. Type 2 MI is common in the ED and can result from vigorous exercise (common in athletes after marathons), sepsis, trauma and tachydysrhythmias including SVT. Type 5: MI associated with coronary bypass surgery.

EKG/ECG 143

EKG/ECG Sepsis EMS Outcomes 143

Don't Forget the Bubbles

MAY 6, 2024

Reviewed by: Tasnim Ransome and Spyridon Karageorgos Article 3: Which Sepsis Scoring Tools Perform Best? Organ Dysfunction in Children With Blood Culture-Proven Sepsis: Comparative Performance of Four Scores in a National Cohort Study. Each patient was scored using the four sepsis tools. Schlapbach, L.J., Hagenbuch, N.,

Sepsis 75

Sepsis Pediatrics Outcomes Documentation/Coding 75

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. Other organ system involvement & hypotension/low perfusion affect EtCO 2.

Emergency Department 94

Emergency Department Blood Transfusions Resuscitation Sepsis 94

EMDocs

JANUARY 23, 2024

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., Episode 93: BRASH syndrome Background: Brash syndrome has 5 components: bradycardia, renal failure, AV nodal blocker, shock, hyperkalemia.

Shock 113

Shock Dehydration Sepsis EKG/ECG 113

EMDocs

MARCH 9, 2025

Well keep it short, while you keep that EM brain sharp. Other children at risk for osteomyelitis include those with sickle cell disease , sepsis , an indwelling catheter , and immunodeficiency (e.g., Infectious disease expertise is useful as the optimum duration of treatment is not well established.

Pediatrics 52

Pediatrics EMS Infectious Diseases Fractures 52

Taming the SRU

MARCH 10, 2024

critical AS, ASD, HCM) Arrhythmogenic right ventricular cardiomyopathy Pulmonary embolism Thoracic aortic dissection Transient occult shock Sepsis Hemorrhagic shock (ex. Can’t miss ED diagnosis for syncope Brady/tachy dysrhythmia, arrhythmias such as ARVC, channelopathy (Brugada) Acute MI Structural heart disease (ex.

EKG/ECG 97

EKG/ECG Shock Wellness EMS 97

Sensible Medicine

JULY 29, 2024

Yet the failure of the hospital readmission penalty policy and sepsis protocols expose the risks of implementing a policy because it sounds good. Yet policies mostly escape this challenge. It seems all a policy needs is a strong champion and plausibility. ” Sensible Medicine is a reader-supported publication.

Outcomes 118

Outcomes Research Sepsis Emergency Department 118

PulmCCM

FEBRUARY 5, 2024

In 18 severe sepsis patients in 3 years at one center who underwent PET scanning (apparently done ad hoc), 14 of the 18 had positive tests, and 11 were true positives, leading to surgery in 2 and pacemaker removal in 2 (and longer / new antibiotics in 2). Ultrasound is well-suited for identifying most serious biliary system abnormalities.

Best Practices 111

Best Practices Ultrasounds Infectious Diseases Sepsis 111

Pediatric EM Morsels

APRIL 7, 2023

Unfortunately, it can cause so many other complications – Sepsis , acute chest syndrome , and hepatopathy. Observation, interaction with patient, as well as parent information is key to bring the whole picture together!

Stroke 130

Stroke Pediatrics Seizures Sepsis 130

EMDocs

NOVEMBER 1, 2023

1 , 4 If presenting later in course or with an intra-abdominal perforation, patients are more likely to show signs of sepsis and hemodynamic instability. VBG with lactate 4 – may show low pH with elevated lactate Cardiac biomarkers – to evaluate for cardiac etiology in those presenting with chest pain or type II NSTEMI in those with sepsis.

Operations 93

Operations Radiology Radiology Fluid Resuscitation 93

EMDocs

JULY 13, 2024

Incidence, treatment and outcome of peripartum sepsis. Am J Obstet Gynecol. 1985 Dec 1;153(7):737-9. doi: 10.1016/0002-9378(85)90335-7. PMID: 4073137. Kankuri E, Kurki T, Carlson P, Hiilesmaa V. Acta Obstet Gynecol Scand. 2003 Aug;82(8):730-5. doi: 10.1034/j.1600-0412.2003.00265.x. 1600-0412.2003.00265.x. PMID: 12848644. Moldenhauer, Julie S.

OB/GYN 89

OB/GYN EMS Sepsis Fluid Resuscitation 89

EMDocs

JUNE 22, 2024

The newborn is doing well, but the mother is complaining of shortness of breath and chest pain. “Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation.” A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. RR 28, SpO2 89% on 6L NC. link] j.ajog.2016.03.012

EMS 111

EMS Resuscitation Blood Transfusions Seizures 111

Taming the SRU

MARCH 30, 2023

10.1186/s13613-020-00658-8 P: A total of 761 patients from two separate cohorts found to have septic shock I: Diastolic shock index C: Comparison to a variety of well adopted markers of morbidity and mortality, including systolic shock index, SOFA score, APACHE II score, lactate, etc. Ann Intensive Care 2020;10(1):41. decreased DSI values).

Shock 52

Shock Outcomes Sepsis Resuscitation 52

EMDocs

OCTOBER 19, 2024

Leukocytosis, as well as mild leukopenia, are common. Blood cultures: Blood cultures are rarely positive; however, should be obtained if suspicion for sepsis is present or if the patient is immunocompromised. [2][3] 2][3] Evaluation Labwork CBC: A white blood cell count is variable and nonspecific.

EMS 110

EMS Pediatrics Sepsis Airway Management 110

Dr. Smith's ECG Blog

OCTOBER 26, 2010

He was rushed by residents into our critical care room with a diagnosis of STEMI, and they handed me this ECG: There is sinus tachycardia with ST elevation in II, III, and aVF, as well as V4-V6. Furthermore, notice the well-formed Q-waves in inferior leads. The patient was suffering from severe dehydration, possibly with sepsis.

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

Northwestern EM Blog

MARCH 1, 2025

There are several etiologies including viral pneumonia, bacterial pneumonia, sepsis, trauma, and pancreatitis. In this study, they found that prone positioning resulted in significant improvement in oxygenation, as well as a 50% decrease in mortality at 28 days (Guerin et. Adjust all tubing and reassess connections.

Emergency Department 52

Emergency Department Fractures EKG/ECG Wellness 52

ACEP Now

MAY 10, 2024

Patients with flank pain (which would suggest pyelonephritis) as well as patients meeting two or more SIRS criteria (which would suggest sepsis) comprise a higher risk group. For simplicity, we will focus only on the patients with suspected lower urinary tract infection (UTI).

Infectious Diseases 98

Infectious Diseases Sepsis Emergency Department Administration 98

EMDocs

NOVEMBER 27, 2023

ESR & CRP – nonspecific and typically elevated Blood culture – if presenting with sepsis Imaging: Consider a chest radiograph in patients with pulmonary symptoms to evaluate for associated pneumonitis, pleural effusions, cardiomegaly. 2 DRESS Syndrome has a 10% mortality rate with the primary cause of mortality being hepatic necrosis.

EMS 96

EMS Sepsis Burns EKG/ECG 96