EMDocs

JANUARY 11, 2025

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. 2-4, 6 If there is a concern for perforation or sepsis, surgical consultation, blood cultures, empiric antibiotics, and fluids are recommended.

EMS 98

EMS Sepsis Shock Fluid Resuscitation 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

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.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 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. Gut feelings: the intelligence of the unconscious.

Emergency Department 59

Emergency Department Mass Casualty Incidents Documentation/Coding Sepsis 59

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,

Sepsis 94

Sepsis Shock Resuscitation Fluid Resuscitation 94

Pediatric EM Morsels

NOVEMBER 17, 2023

Differences in intubation outcomes for pediatric patients between pediatric and general Emergency Departments. Intubation practice and outcomes among pediatric emergency departments: A report from National Emergency Airway Registry for Children (NEAR4KIDS). That sounds reasonable, so what has changed? 0.41), p < 0.001.

Pediatrics 190

Pediatrics Emergency Department Outcomes Sepsis 190

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.

Sepsis 94

Sepsis Stroke Shock Infectious Diseases 94

AENJ: Current Issue

DECEMBER 19, 2024

Background: Delays in sepsis recognition contribute to delays in antibiotic administration, which lead to increased morbidity and mortality in patients with sepsis. Our objective was to create an Emergency Department (ED) Code Sepsis Nurse-led team to reduce the time to antibiotics and mortality in patients with sepsis.

Documentation/Coding 40

Documentation/Coding Sepsis Outcomes Emergency Department 40

Don't Forget the Bubbles

NOVEMBER 27, 2023

Four-year-old Ed is being resuscitated for presumed Invasive Group A Streptococcal Sepsis from tonsilitis. In middle-to-high-income countries, after 40-60ml/kg of fluid resuscitation, the Surviving Sepsis Campaign International Guidelines recommend using vasoactive drugs. After 40ml/kg of IV 0.9% The CRT is unchanged.

Shock 143

Shock Sepsis Fluid Resuscitation Resuscitation 143

The Trauma Pro

AUGUST 25, 2023

They tried to perform a systematic review and meta-analysis of studies that compared outcomes in splenectomy vs. angioembolization patients. We have no idea if the numbers of T- and B-cells seen and the antibody titers are actually enough to avoid overwhelming post-splenectomy sepsis. Not very precise, I know. But what would EAST say?

Sepsis 187

Sepsis Research Outcomes Hospitals 187

Broome Docs

SEPTEMBER 3, 2024

In a surprise to no one who reads First10EM, clinical judgment is better than all decision tools for sepsis Knack SKS, Scott N, Driver BE, Prekker ME, Black LP, Hopson C, Maruggi E, Kaus O, Tordsen W, Puskarich MA. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients.

Sepsis 94

Sepsis Emergency Department Outcomes Hospitals 94

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.

EKG/ECG 195

EKG/ECG Documentation/Coding Sepsis COPD 195

EMDocs

JANUARY 25, 2025

PCP Pneumonia, Sepsis) can be discharged with initiation of Antiretroviral Therapy in consultation with Infectious Disease (ID) physician with full ID evaluation outpatient. 0000000000000305 Kazumi Y (2023) The Epidemiology and Outcomes of Leukopenia in Different Populations and Regions. Curr Opin Hematol. 2017;24(1):46-53. Gedefie, A.,

EMS 95

EMS Infectious Diseases Allergic Reactions Fluid Resuscitation 95

Don't Forget the Bubbles

MAY 6, 2024

Outcomes included clinical status when urine culture was available, subsequent antibiotic treatment within seven days and subsequent UTI within 30 days. The primary outcome was the successful intubation on the second attempt. Secondary outcomes included tracheal intubation adverse events (TIAEs) or severe desaturation.

Sepsis 75

Sepsis Outcomes Pediatrics Documentation/Coding 75

EMDocs

AUGUST 24, 2023

Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis: A Diagnostic Study. Exclusion criteria: Severe coagulopathy A platelet count below 20, 000 INR > 6.0 Difference of 10.6% (95% CI 3.3 – 17.9%) 30-240 min (entire study population): 31.4% Difference of 12% (95% CI 5.4

Administration 96

Administration Sepsis Shock Emergency Department 96

RebelEM

FEBRUARY 19, 2024

The 2021 Surviving Sepsis Campaign Guidelines suggest starting vasopressors peripherally rather than delaying infusion until a CVC is placed [2]. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. References: Yerke JR et al. CHEST 2024. PMID: 37611862 Evans L et al.

Administration 137

Administration Sepsis EMS Shock 137

Emergency Medicine Cases

MARCH 26, 2019

In this podcast Dr. 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? How does SIRS, qSOFA and NEWS compare in predicting poor outcomes in septic patients? and many more.

Sepsis 40

Sepsis Shock EMS Resuscitation 40

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. The background for cash giveaways stem from the association of low income and worse health outcomes. The primary outcome was positive but there were caveats.

Outcomes 120

Outcomes Research Sepsis Emergency Department 120

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 95

Sepsis Research Stroke Academics 95

Critical Care Now

AUGUST 18, 2024

ClinicalTrials.gov: NCT025174897 Background: Community-acquired pneumonia (CAP) can lead to significant pulmonary and systemic inflammation, resulting in impaired gas exchange, sepsis, organ failure, and increased mortality. The primary outcome showed a 28-day mortality of 6.2% in the hydrocortisone group compared to 11.9%

Outcomes 93

Outcomes Sepsis Administration EMS 93

Don't Forget the Bubbles

MARCH 4, 2024

This was a secondary outcome embedded in the Travel Fever study – a multi-centre, retrospective diagnostic accuracy study for imported malaria. Reviewed by: John Coveney Article 2: How do we define sepsis in children? International Consensus Criteria for Pediatric Sepsis and Septic Shock. Published online January 21, 2024.

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

American Medical Compliance

APRIL 16, 2024

Our Continuing Medical Education (CME) program is committed to enhancing the knowledge, skills, and professional performance of healthcare providers to improve healthcare outcomes. Furthermore, prompt antibiotic treatment of illnesses, such as sepsis, decreases morbidity and saves lives.

Leadership 97

Leadership Sepsis Outcomes Hospitals 97

The Skeptics' Guide to EM

FEBRUARY 17, 2018

Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. Case: EMS is dispatched to a retirement […] The post SGEM#207: Ahh (Don’t) Push It – Pre-Hospital IV Antibiotics for Sepsis. Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial.

Sepsis 40

Sepsis Hospitals Fluid Resuscitation Administration 40

EMDocs

NOVEMBER 25, 2023

Spoon Feed In this multicenter, randomized controlled trial comparing suturing the fingernail back onto the nail bed versus simply covering the nail bed with a non-adherent dressing after repair of a nail bed injury, there was no statistically significant difference in infection rate or cosmetic outcome. 3: High or Low Fluid Volume in Sepsis?

Sepsis 70

Sepsis Emergency Department Pediatrics Academics 70

RebelEM

FEBRUARY 8, 2024

patients with more discrepant readings had NIBP checked more frequently) Some patients were on multiple vasopressors, but for an unclear reason the authors decided to only evaluate the dose of norepinephrine MAP discrepancy is not a patient oriented outcome (i.e. to 1.12; p = 0.03 to 0.99; p <0.01 to 1.09; p = 0.01 to 1.37; p <0.01

Resuscitation 123

Resuscitation Outcomes EMS Sepsis 123

Critical Care Now

JUNE 30, 2024

The latest Surviving Sepsis Campaign (SSC 2021) guidelines say the following about albumin in in sepsis: The lack of proven benefit and higher cost of albumin compared to crystalloids contributed to our strong recommendation for the use of crystalloids as first-line fluid for resuscitation in sepsis and septic shock.

Sepsis 52

Sepsis Fluid Resuscitation Shock Resuscitation 52

Critical Care Now

JULY 14, 2024

For example, let’s say I want to examine the efficacy of using lemonade to treat sepsis (an absurd, clinically improbable example made to illustrate the principles discussed here – although the LOVIT trial did happen… ). Three studies were included – ARREST, Prague OHCA and INCEPTION.

Resuscitation 98

Resuscitation CPR Outcomes Sepsis 98

Dr. Smith's ECG Blog

MARCH 30, 2014

Then they were worried about sepsis as an etiology of hypotension. Then she had some RUQ tenderness which led to a long process of evaluation for an abdominal source of sepsis, which turned up negative. Outcome and Analysis: ECG 1 is diagnostic of inferior and right ventricular MI. Was there pulmonary edema?

EKG/ECG 52

EKG/ECG Outcomes Shock Sepsis 52

EMDocs

JULY 13, 2024

Favorable infertility outcomes following anti-tubercular treatment prescribed on the sole basis of a positive polymerase chain reaction test for endometrial tuberculosis. Incidence, treatment and outcome of peripartum sepsis. Plasma cell endometritis is associated with Chlamydia trachomatis infection. Am J Clin Pathol.

OB/GYN 90

OB/GYN EMS Sepsis Fluid Resuscitation 90

The Skeptics' Guide to EM

JUNE 6, 2020

Background: I think we have covered sepsis more often than any other topic on the SGEM. It was the landmark paper published 19 years ago by Dr. Emanuel Rivers on early goal directed therapy in the treatment of severe sepsis and septic shock that sensitized the medical community ( Rivers et al NEJM 2001). increase in MAP).

Sepsis 52

Sepsis Shock Resuscitation Administration 52

Don't Forget the Bubbles

JUNE 19, 2023

It is useful to know that there are two kinds of weight curves: Descriptive , in which nearly all mothers and their children are included with few exclusion criteria, and Prescriptive , in which groups of women with pathologies that affect neonatal morbidity and mortality outcomes have been excluded. Eur J Pediatr 2016;175:1047-57.

Pediatrics 143

Pediatrics Ultrasounds Hyperthermia / Hypothermia Sepsis 143

RebelEM

JULY 17, 2023

Range 5 to 9) Etomidate: 7.0 Range 5 to 9) Diff -0.2; 95% CI -1.4

Outcomes 97

Outcomes Emergency Department Administration Resuscitation 97

Emergency Medicine Journal

MAY 23, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension by Shapiro et al Topic: sepsis Outcome rating: head turner Several studies (FEAST, CLASSIC) have challenged the benefit of large volumes of fluid for septic shock.

Sepsis 52

Sepsis Resuscitation Shock Outcomes 52

JournalFeed

AUGUST 1, 2020

We cover pros and cons of antibiotics for dog bites, risk of delayed antibiotics in severe infection, immediate (<1h) vs early (<3h) antibiotic outcomes, and the largest meta-analysis to date on POCUS for cellulitis vs abscess. Here is the JournalFeed Podcast for the week of July 27-31, 2020.

Sepsis 52

Sepsis Outcomes 52

Don't Forget the Bubbles

MAY 31, 2023

What outcomes did they look at? Was the outcome accurately measured to minimise bias? The inability to test for SARS-CoV-2 antibodies may have led to an underestimation of the impact of the virus on the reported outcomes. All ED visits that met the criteria for ‘new onset diabetes’ or DKA (‘decompensation’) were included.

Emergency Department 135

Emergency Department Research Documentation/Coding Outcomes 135

The Skeptics' Guide to EM

FEBRUARY 23, 2019

Association Between Early Intravenous Fluids Provided by Paramedics and Subsequent In-Hospital Mortality Among Patients With Sepsis. Association Between Early Intravenous Fluids Provided by Paramedics and Subsequent In-Hospital Mortality Among Patients With Sepsis. Date: February 22nd, 2019 Reference: Lane et al. Reference: Lane et al.

Sepsis 52

Sepsis Administration Documentation/Coding Hospitals 52