EMDocs

DECEMBER 1, 2024

The disease is generally mild, but in untreated cases, it can lead to more severe outcomes, especially in patients with underlying conditions such as glucose-6-phosphate dehydrogenase deficiency. Even though the disease often resolves spontaneously, prompt antibiotic therapy is essential for optimal outcomes. pregnant patients).

EMS 96

EMS Infectious Diseases Shock Airway Management 96

RebelEM

DECEMBER 17, 2024

A large observational study of > 2000 patients found an association with fever at presentation and ICU survival for patients with severe sepsis or septic shock ( Sunden-Culberg 2017 ). Importantly, all of the patients in this study had septic shock requiring vasopressors and mechanical ventilation. PMID: 26436473 Schortgen F et al.

Sepsis 75

Sepsis Shock EMS Emergency Department 75

Critical Care North Hampton

JUNE 12, 2025

Explore the critical link between ICU-acquired weakness and cardiogenic shock in patients requiring mechanical support, highlighting biomarkers and outcomes.

Shock 84

Shock Outcomes Research 84

PulmCCM

APRIL 14, 2025

SEP-1 was pushed through without waiting for the outcomes of three ongoing multicenter trials testing goal-directed therapy for sepsis. The Effect of Severe Sepsis and Septic Shock Management Bundle (SEP-1) Compliance and Implementation on Mortality Among Patients With Sepsis : A Systematic Review. Ann Intern Med. 2025 Feb 18.

Sepsis 93

Sepsis Infectious Diseases Administration Shock 93

PulmCCM

DECEMBER 3, 2024

Maintaining a mean arterial pressure (MAP) of 65 mm Hg has been advised for patients with sepsis and other forms of vasodilatory shock. More than a dozen randomized controlled trials (RCTs) have sought to identify whether higher or lower MAP targets produce better outcomes in critically ill patients with shock. PMID: 39556565.

Sepsis 75

Sepsis Shock Outcomes Hospitals 75

Mount Sinai EM

AUGUST 20, 2023

Activate ECMO team early, cardiac arrest due to LAST might be prolonged (especially with bupivacaine) and there’s several case reports with good outcomes after ECMO. Start intralipid emulsion 20% bolus 1.5 mg/kg and infusion, repeat bolus until ROSC (max total dose of Intralipid solution 12 ml/kg).

Seizures 243

Seizures Shock Outcomes 243

Don't Forget the Bubbles

JUNE 2, 2025

Reviewed by the PICSTAR team Article 2: Prediction of good neurological outcome after return of circulation following paediatric cardiac arrest Scholefield BR, Tijssen J, Ganesan SL, et al. Prediction of good neurological outcome after return of circulation following paediatric cardiac arrest: A systematic review and meta-analysis.

Sepsis 62

Sepsis Shock Outcomes Research 62

AED Leader

JULY 2, 2025

A semi automatic AED advises the rescuer to press a shock button after analyzing the heart rhythm. A fully automatic AED delivers the shock on its own after an audible countdown. They are often trained to manage the rescue process and prefer having final control over shock delivery. It is not just about pushing a button.

Shock 52

Shock CPR Operations Leadership 52

EMDocs

JANUARY 4, 2025

PMID: 39480221 #2: Albumin for AKI in Septic Shockor Not Spoon Feed Administration of early albumin to patients in septic shock with acute kidney injury (AKI) was associated with worse outcomes. 2024 Oct 18:S0012-3692(24)05315-7. doi: 10.1016/j.chest.2024.10.012. 2024.10.012.

Ultrasounds 97

Ultrasounds Shock Pediatrics Administration 97

The Bottom Line

JUNE 27, 2025

A retrospective study at a major trauma centre Emergency Medicine Australasia Early ADL ability assessment and cognitive screening as markers of post-discharge outcomes after surviving an out-of-hospital cardiac arrest.

Emergency Department 69

Emergency Department Emergency Nursing Resuscitation Pediatrics 69

RebelEM

NOVEMBER 6, 2023

Background Information: Vasoplegic shock is defined as hypotension with normal or increased cardiac output and can commonly occur in post-cardiac surgery patients having received cardiopulmonary bypass. Hydroxocobalamin Versus Methylene Blue for the Treatment of Vasoplegic Shock Associated With Cardiopulmonary Bypass. 2023 Jul 19.

Shock 65

Shock Administration Academics Hospitals 65

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. If sepsis or septic shock is present, aggressive fluid resuscitation and empiric antibiotics covering intra-abdominal flora should be administered. Abdominal pain may be absent in up to 60%.

EMS 94

EMS Sepsis Shock Fluid Resuscitation 94

AED Leader

JULY 7, 2025

The goal should be to get a defibrillator shock to a victim within three minutes. Both types of AEDs analyze the patient’s heart rhythm and determine if a shock is necessary. The only difference is how the shock is delivered. A semi automatic AED will prompt the rescuer to push a flashing button to deliver the shock.

CPR 52

CPR Shock Pediatrics Best Practices 52

Dr. Smith's ECG Blog

MAY 30, 2023

A 50-something man presented in shock with severe chest pain. The patient was in clinical shock with a lactate of 8. This confirms inferior, posterior, lateral, and RV MI RV MI often leads to shock and (systolic) hypotension. RVMI explains part of the shock. His prehospital ECG was diagnostic of inferior posterior OMI.

Shock 97

Shock EKG/ECG Academics Stroke 97

PulmCCM

JUNE 5, 2025

For sepsis and septic shock, the committee suggested delivering up to 30 ml/kg of crystalloid at the time of presentation. Patients in cardiogenic shock due to left ventricular failure should not receive volume resuscitation, authors advised. For traumatic hemorrhagic shock, a restrictive approach was advised. Mekontso et al.

Sepsis 52

Sepsis Resuscitation Shock Emergency Department 52

RebelEM

DECEMBER 4, 2024

PMID: 25701296 The SGEM: Shock Through the Heart (Ottawa Aggressive Atrial Fibrillation Protocol) ALiEM: Atrial Fibrillation Rate Control in the ED: Calcium Channel Blockers or Beta Blockers. Thirty-day Outcomes of Emergency Department Patients Undergoing Electrical Cardioversion for Atrial Fibrillation or Flutter.

Emergency Department 93

Emergency Department Stroke EMS Shock 93

St. Emlyn

OCTOBER 21, 2024

Critical appraisal of an observational study in JAMA suggests a better outcome with AP, but there are many biases in this study. FOAMed @stemlyns The post AP or AL pad position for first choice shock in VF? St.Emlyn's - Emergency Medicine #FOAMed Should we use AP or AL pad position first for defibrillation in VF/VT cardiac arrest.

Shock 52

Shock Outcomes 52

Sensible Medicine

APRIL 1, 2024

In the same session, Jacob Eifer Møller, MD, PhD, from Odense University in Denmark, will present the results of the DanGer-Shock trial. I rank this trial—of the Impella ventricular assist device in patients with cardiogenic shock—as one of the most important trials of this decade. I predict no benefit.

Shock 138

Shock Wellness Outcomes 138

Dr. Smith's ECG Blog

FEBRUARY 10, 2025

Acute hyperkalemia in the emergency department: a summary from a Kidney Disease: Improving Global Outcomes conference. BRASH syndrome: Bradycardia, Renal Failure, AV blockade, Shock, and Hyperkalemia. Eur J Emerg Med 2020. Durfey et al. Severe hyperkalemia: can the electrocardiogram risk stratify for short-term adverse events.

EKG/ECG 125

EKG/ECG Shock Operations Emergency Department 125

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

The Skeptics' Guide to EM

FEBRUARY 11, 2023

Intervention: * Vector Change Defibrillation: Pads are placed in an anterior-posterior pad placement after standard anterior-anterior configuration following the third shock with standard defibrillation. first appeared on The Skeptics Guide to Emergency Medicine. Date: February 7, 2023 Reference: Cheskes et al. .

Shock 56

Shock CPR Hyperthermia / Hypothermia Hospitals 56

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 85

Sepsis Shock Resuscitation Fluid Resuscitation 85

Don't Forget the Bubbles

NOVEMBER 18, 2024

Research and guidelines from Australian centres, like those published by the Australian and New Zealand Neonatal Network (ANZNN), emphasize early detection and management to improve outcomes. Check electrolytes and consider the diagnosis, especially if the infant shows signs of shock or has a family history suggestive of CAH.

Sepsis 57

Sepsis Shock Hyperthermia / Hypothermia Administration 57

AED Leader

JULY 1, 2025

The American Heart Association emphasizes that minimizing these interruptions is essential for improving outcomes from sudden cardiac arrest. Faster time to shock: By analyzing during compressions, the CR2 can be ready to deliver a shock the moment it’s needed, saving precious seconds.

CPR 52

CPR Operations Resuscitation Shock 52

Critical Care North Hampton

JUNE 26, 2025

Primary outcomes: Accuracy of 18 classification tasks (e.g., No prospective data on clinical outcomes or patient impact. Its view-agnostic, multitask design outperforms prior AI models, but retrospective data, interpretability concerns, and lack of prospective outcomes temper enthusiasm. Manoj’s Sonobytes! Ouyang et al.

Ultrasounds 66

Ultrasounds Sepsis Radiology Radiology 66

PulmCCM

OCTOBER 7, 2024

Midodrine A 75-year-old woman seems to have recovered from septic shock, but each time her norepinephrine infusion is reduced from 0.05 It was reported to improve blood pressure in children with septic shock in 1979, and in the treatment of orthostatic hypotension in 1981. mcg/kg/min, her mean arterial pressure falls below 65 mm Hg.

Shock 98

Shock Outcomes 98

Sensible Medicine

AUGUST 26, 2024

In population studies, AF associates with worse outcomes. In CABANA, ablation reduced AF episodes on monitors, but hard outcomes did not differ significantly. The problem here is that it’s hard to compare a subjective outcome (like feeling better) when one group of patients get a procedure and the other group gets tablets.

Stroke 108

Stroke Outcomes Shock Research 108

PulmCCM

JUNE 12, 2025

In the pragmatic, UK-based randomized A2B trial (Walsh et al JAMA 2025), patients sedated with clonidine infusions appeared to have virtually identical outcomes (in terms of sedation, duration of ventilation, and mortality) as those assigned to dexmedetomidine or propofol. such off-label use is vanishingly rare. Representative Population?

Wellness 52

Wellness Shock Outcomes 52

RebelEM

JANUARY 18, 2024

It is well-established that earlier recognition and treatment can lead to better outcome for these patients . Three outcomes were evaluated, with none being deemed the primary outcome. Background: Sepsis remains one of the leading causes of morbidity and mortality. to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

Sepsis 127

Sepsis Hospitals Administration Outcomes 127

ACEP Now

JULY 7, 2023

2,3 In general, patients who develop cardiac arrest with an initial rhythm of VT or VF tend to have favorable outcomes compared to patients who develop cardiac arrest from either asystole or pulseless electrical activity. Initial guidelines defined “refractory” as VT or VF occurring despite three shocks from a cardiac defibrillator.

Resuscitation 98

Resuscitation Shock Stroke Hospitals 98

EMDocs

APRIL 25, 2025

Blood Products Over Crystalloids for Volume Resuscitation: If available, whole blood or blood products should be used to restore circulation in hemorrhagic shock, as excessive crystalloid fluids can dilute clotting factors and worsen coagulopathy.

Pediatrics 95

Pediatrics EMS Head Injuries Hyperthermia / Hypothermia 95

EMDocs

JUNE 29, 2024

. #1: Re-DOSE VF… DSED for Shock-Refractory VF? Source The impact of alternate defibrillation strategies on shock-refractory and recurrent ventricular fibrillation: A secondary analysis of the DOSE VF cluster randomized controlled trial. Resuscitation. 2024 May;198:110186. doi: 10.1016/j.resuscitation.2024.110186. 2024.110186.

Shock 88

Shock Emergency Department Resuscitation Administration 88

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? How does SIRS, qSOFA and NEWS compare in predicting poor outcomes in septic patients? Which fluid and how much fluid is best for resuscitation of the septic shock patients?

Sepsis 40

Sepsis Shock EMS Resuscitation 40

Taming the SRU

SEPTEMBER 21, 2023

Exclusion criteria were pre-intubation hypotension, use of topical anesthesia, or missing data including primary outcome, patient weight, etomidate / ketamine dose. Primary outcome was post-intubation hypotension, defined as SBP < 100mg Hg within the first 15 minutes post-intubation.

Outcomes 105

Outcomes Emergency Department Shock 105

Critical Care North Hampton

JUNE 25, 2025

This training helps improve outcomes. In the fast-paced environment of acute and critical care, every decision counts, and the ability to interpret diagnostic imaging can make all the difference in patient outcomes. Manoj’s Sonobytes! Imaging technology is rapidly advancing and integrating into clinical practice.

Radiology 66

Radiology Radiology Ultrasounds Patient Safety 66

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.

Administration 88

Administration Sepsis Shock Emergency Department 88

EMDocs

DECEMBER 23, 2024

Do we still shock? Gorgels et al (5) looked at procainamide vs lidocaine and again and primary outcome was VTach termination. After a little bit of etomidate and a quick shock, the patient was back in normal sinus rhythm and cardiology was consulted for evaluation. If the patient has a BP of 60/palp, its easy, right? Should you?

EKG/ECG 74

EKG/ECG Wellness Shock EMS 74