PulmCCM

JANUARY 23, 2025

Various new “sepsis tests” have come to market or will soon, claiming to solve the problem of diagnostic imprecision in the early management of suspected sepsis. The lack of a reliable diagnostic test or universally accepted criteria to diagnose sepsis leads to significant challenges in clinical practice and research.

Sepsis 45

Sepsis Wellness Emergency Department Research 45

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

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

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 93

Sepsis Research Stroke Academics 93

Pediatric EM Morsels

FEBRUARY 2, 2024

However It is common to have no focal findings on physical exam for systemic illnesses related to travel (Abdel-Haq 2021) Travel-related Illness: Management Children with evidence of severe life-threatening illness (signs of hemorrhage , petechiae , meningismus , shock or AMS ) require aggressive supportive therapy and very likely empiric antibiotics (..)

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161

Taming the SRU

SEPTEMBER 1, 2023

to divert the plane).

Sepsis 95

Sepsis Fractures Documentation/Coding Administration 95

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 119

EKG/ECG Sepsis Wellness Documentation/Coding 119

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

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 83

Dehydration Fluid Resuscitation Administration Resuscitation 83

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 Outcomes Pediatrics Documentation/Coding 75

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

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 96

EKG/ECG Shock Wellness EMS 96

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 100

Sepsis Best Practices Hospitals Outcomes 100

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 88

EMS Sepsis Shock Fluid Resuscitation 88

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

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

PulmCCM

MARCH 4, 2024

While not IQ tests per se , the tests (branded as Cognitron ) purport to correlate well with, and to be indexed to, formal IQ tests. Thanks to the large data set, however, other demographics were well-represented and analyzable. Selection bias is baked into any self-selected survey sample such as this.

Sepsis 52

Sepsis CDC Pediatrics Documentation/Coding 52

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 110

Outcomes Research Sepsis Emergency Department 110

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 80

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 80

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

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 107

EMS Resuscitation Blood Transfusions Seizures 107

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 79

Emergency Department Blood Transfusions Resuscitation Sepsis 79

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 Administration Emergency Department 98

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 98

Shock Dehydration Sepsis EKG/ECG 98

Don't Forget the Bubbles

JUNE 19, 2023

Fetal Growth Restriction (FGR) and dysmaturity are common in neonatology and are a leading cause of morbidity during the neonatal period, as well as later in life. According to the Obstetric resident, the placenta looked a little small. In everyday medical practice, it is sometimes difficult to pinpoint the cause of the growth restriction.

Pediatrics 143

Pediatrics Ultrasounds Hyperthermia / Hypothermia Sepsis 143

Core Ultrasound

MARCH 25, 2024

If one is going to access the collapsibility of the IVC one should probably look at it in the transverse plane as well 3. Examining the IVC in the longitudinal plain alone assumes that the IVC collapses in a sagittal fashion on all pts, which is not necessarily true ( [link] ). For this we use clinical judgement, US findings, PE findings.

Administration 75

Administration Sepsis Ultrasounds Outcomes 75

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 99

EMS Pediatrics Sepsis Airway Management 99

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 78

Operations Radiology Radiology Fluid Resuscitation 78

Sensible Medicine

AUGUST 14, 2024

In popular (lay) understanding, SIDS represents a common danger that a well-cared for and apparently healthy baby will suddenly and terrifyingly be found dead in the morning. This sort of sepsis would produce many of the common autopsy findings. What do we know about SIDS and how effective back sleep is at reducing it?

CDC 95

CDC Sepsis Research Pediatrics 95

Emergency Medicine Ireland

JULY 3, 2023

Type 5 is the big bucket where they put all the left over disease that cause both kidney and heart failure eg things like amyloid, or sepsis or cirrhosis. There are of course much more complex neurohumoral, inflammatory type cytokiney thingies going on but as you can tell they are well over my head so I’ve skipped them for now.

Sepsis 96

Sepsis Shock Wellness Documentation/Coding 96

Emergency Medicine Ireland

JANUARY 22, 2024

It’s clear that the features listed above are fairly non specific and like always it’s likely just sepsis. There may well be some co existing sepsis so give some antibiotics. There is occasionally some coexisting adrenal insufficiency so you’ll treat that as well. Firstly do a bit of resuscitation.

Sepsis 52

Sepsis Resuscitation Wellness Administration 52