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.”

Sepsis 50

Sepsis Shock Hospitals 50

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.

Sepsis 74

Sepsis Pediatrics Shock 74

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

JournalFeed

MARCH 23, 2024

Tuesday Spoon Feed: This Bayesian network meta-analysis of RCTs indirectly compares hydrocortisone + fludrocortisone to hydrocortisone alone or placebo in septic shock and finds superiority with the combination regimen. For access to more, please visit JournalFeed.org for details about becoming a member.

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Sepsis Shock Research 52

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 62

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

PulmCCM

APRIL 29, 2024

The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1). The stakes are going up.

Infectious Diseases 52

Infectious Diseases Sepsis Administration Shock 52

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 […]

Sepsis 52

Sepsis Shock 52

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.

Dislocations 85

Dislocations Shock EMS Sepsis 85

Life in the Fast Lane

JULY 26, 2023

Pramod Chandru Network Five: Critical Care Network Five Emergency Medicine Journal Club Episode 21 - Critical Care reviewing papers on cardiogenic shock, intravenous fluids in sepsis and lung protective ventilation strategies.

Sepsis 52

Sepsis Shock 52

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.

Anaphylaxis 69

Anaphylaxis Shock Sepsis Stroke 69

AENJ: Current Issue

MAY 8, 2024

The results are discussed in the context of averting adverse outcomes associated with sepsis/septic shock, intensive care unit admission, and all-cause mortality within a 1-month time frame.

Emergency Department 45

Emergency Department Outcomes Research Sepsis 45

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

RebelEM

FEBRUARY 7, 2024

Triple antibiotic coverage is recommended. Suggested regimens include: Ampicillin AND Gentamicin AND Clindamycin OR Metronidazole Update tetanus vaccination Usually requires dilation and curettage to remove any retained products of conception or foreign bodies.

Sepsis 75

Sepsis Shock Hospitals Ultrasounds 75

University of Maryland CC Project

SEPTEMBER 9, 2021

Chee Chan, a Pulmonary Critical Care physician and Medical Director of the Medical Intermediate Care Unit at MedStar Washington presents an interactive discussion on shock as part of the DC5 lecture series.

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Shock Blood Transfusions Sepsis 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 72

Taming the SRU

MAY 5, 2023

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. doi:10.1056/NEJMoa2212663 BACKGROUND Sepsis, including severe sepsis and septic shock, is a frequently encountered condition in the emergency department and carries a high mortality rate. N Engl J Med. 2023;388(6):499-510. 2021, Im, Kang et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Thinking Critical Care

MARCH 18, 2024

Date: June 15 10am-4:30pm EST (7am-1:30pm PST) Format: one-day, 6.5 Date: June 15 10am-4:30pm EST (7am-1:30pm PST) Format: one-day, 6.5 Date: June 15 10am-4:30pm EST (7am-1:30pm PST) Format: one-day, 6.5

Shock 91

Shock Sepsis Academics 91

PHARM

APRIL 28, 2023

How I personalize fluid therapy in septic shock? – PMC — Read on www.ncbi.nlm.nih.gov/pmc/articles/PMC10039545/

Shock 40

Shock Sepsis 40

Taming the SRU

JANUARY 12, 2024

Often AE-ILD is idiopathic, but treatable causes must be excluded (PNA, PE, volume overload) Treatment for AE-ILD should include antibiotics for CAP coverage (specifically including azithromycin), steroids, and respiratory support; consider opportunistic infection if immunosuppressed as well as diuresis as needed for euvolemia HFNC should be favored (..)

Fluid Resuscitation 59

Fluid Resuscitation Pediatrics Sepsis Shock 59

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?

Shock 40

Shock Sepsis Pediatrics Ultrasounds 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.

Administration 67

Administration Sepsis Shock Outcomes 67

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 Shock Resuscitation Outcomes 52

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.,

Shock 86

Shock Dehydration Sepsis EKG/ECG 86

PulmCCM

OCTOBER 30, 2023

Professional Medical Societies Call for Elimination of SEP-1 The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Sepsis 52

Sepsis Shock Hospitals Outcomes 52

PulmCCM

NOVEMBER 27, 2023

Beta-blockers for septic shock (STRESS-L trial) Septic shock deranges multiple complex signaling systems in the body. A meta-analysis of 7 randomized trials (n=503) previously suggested that co-administration of esmolol to blunt vasopressor-induced tachycardia and arrhythmias could reduce mortality in septic shock by one-third.

Sepsis 52

Sepsis Shock Administration Outcomes 52

EMCrit

MARCH 10, 2023

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

Sepsis 67

Sepsis Shock 67

The Skeptics' Guide to EM

JUNE 6, 2020

Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER): A Randomized Trial. Background: I think we have covered sepsis more often than any other topic on the SGEM. Date: June 2nd, 2020 Reference: Permpikul et al.

Sepsis 52

Sepsis Shock Resuscitation Outcomes 52

The Skeptics' Guide to EM

FEBRUARY 24, 2018

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. He writes an […] The post SGEM#208: It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock first appeared on The Skeptics Guide to Emergency Medicine. Adjunctive Glucocorticoid Therapy in Patients with Septic Shock. NEJM January 2018.

Shock 40

Shock Sepsis Emergency Department Resuscitation 40

PEMBlog

OCTOBER 18, 2023

rectally, prompting a sepsis workup given his age. Neonatal Toxic Shock Syndrome C. Neonatal Toxic Shock Syndrome-Like Exanthematous Disease E. Neonatal Toxic Shock Syndrome-Like Exanthematous Disease The patient was diagnosed with Neonatal Toxic Shock Syndrome-Like Exanthematous Disease (NTED). link] Takahashi, N.,

Infectious Diseases 59

Infectious Diseases Shock Pediatrics Wellness 59

PulmCCM

MARCH 4, 2024

New criteria for diagnosis of pediatric sepsis The diagnosis of pediatric sepsis will abandon the so-called SIRS criteria in favor of a simple organ-failure score. A score of 2 or higher on the Phoenix-4 in a child with suspected or confirmed infection would diagnose sepsis.

Sepsis 52

Sepsis CDC Pediatrics Documentation/Coding 52

PulmCCM

FEBRUARY 12, 2024

SCCM Guideline Update: Steroids for Community-Acquired Pneumonia, ARDS, Septic Shock Steroids are good medicine in the ICU, U.S. The 2017 SCCM/ESICM suggestion had been to use steroids for severe septic shock (requiring high-dose or multiple vasopressors). critical care professional societies agree.

Shock 52

Shock Administration Sepsis Fractures 52

JournalFeed

OCTOBER 3, 2020

We cover the new ACEP opioid policy statement, PE response teams during COVID-19, a SMART balanced fluid trial spin-off in septic shock, an AHA statement on drug-induced arrhythmia, and use of POCUS for shoulder dislocation. It’s the JournalFeed Podcast for the week of Sept. 28- Oct 2, 2020.

Dislocations 52

Dislocations Sepsis Shock 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 (..)

Dehydration 244

Dehydration Pediatrics Sepsis EMS 244

Emergency Medicine Ireland

OCTOBER 16, 2023

We’ll start with sepsis. Sepsis is a state of low systemic vascular resistance leading to reduced preload and afterload in the heart. The incidence of dynamic LVOTO in those with septic shock is remarkably high and is reported to be 20% in one study from ICU echo guru Michel Slama. We’ll start with sepsis.

Sepsis 52

Sepsis Shock Wellness 52

RebelEM

NOVEMBER 30, 2023

For those with sepsis, the administration of intravenous fluids (IVF) at the volumes recommended in the Surviving Sepsis Campaign (SSC) requires careful consideration of an individual’s chronic medical conditions and subsequent sensitivity to IVF. Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Am J Emerg Med.

Sepsis 104

Sepsis Fluid Resuscitation Resuscitation Administration 104

Pediatric EM Morsels

FEBRUARY 2, 2024

However, the destination of travel is also important as helminths have distinct geographical distribution.

Infectious Diseases 161

Infectious Diseases Pediatrics Sepsis Documentation/Coding 161