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. The key is to do an assessment, this likely includes having a sneaky peak at the heart and the lungs with ultrasound.

Sepsis 52

Sepsis Resuscitation Wellness Administration 52

EMDocs

MARCH 4, 2024

12 Ultrasound and computed tomography (CT) can both identify CBD and are available in most emergency departments. Ultrasound is cost-effective and radiation-sparing. Ultrasound has approximately 90% sensitivity for detecting common bile duct dilation. 13 CT is also superior to ultrasound in its ability to detect malignancy.

Emergency Department 85

Emergency Department Ultrasounds EMS Radiology 85

Don't Forget the Bubbles

JUNE 19, 2023

There were no issues during the pregnancy, and estimated fetal growth by ultrasound was constant. Differential diagnosis of small babies The differential diagnosis for SGA and growth-restricted babies is extensive: The diagnosis of growth restriction in utero has improved because of the better use of ultrasound but still remains challenging.

Pediatrics 143

Pediatrics Ultrasounds Hyperthermia / Hypothermia Outcomes 143

Emergency Medicine Journal

JULY 24, 2023

An intern says he wants to complete sepsis bundles; a second-year is shooting for more bedside ultrasounds. Beyond them, in the collective treatment area, is a flood. My attending likes to start shifts by asking about our daily goals. As the senior resident, I say I’m working on "volume", but what I really mean is flow.

Sepsis 40

Sepsis Ultrasounds Hospitals 40

Core Ultrasound

MARCH 25, 2024

For example a pt in the ED with sepsis, and a collapsible IVC, dry lungs and no peripheral edema is more likely to benefit from fluid than be harmed Take that same pt, with the same US and physical exam findings and make it 72-hrs later in the ICU after 6-10 L. For this we use clinical judgement, US findings, PE findings.

Administration 98

Administration Sepsis Ultrasounds Outcomes 98

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. 2018, Kuttab, Lykins et al.

Sepsis 52

Sepsis Shock Administration Resuscitation 52

Pediatric Education

FEBRUARY 4, 2024

A right-sided suprarenal mass had been identified on routine ultrasound during the third trimester that was thought to likely be an adrenal hemorrhage. The radiologic evaluation of an ultrasound examination showed a small hypoechoic mass in the area of right adrenal gland that was smaller than previously recorded prenatally.

Ultrasounds 52

Ultrasounds Pediatrics Radiology Radiology 52

ACEP Now

MAY 9, 2024

6 The increasing mortality rate led to an additional emergency regulation in 2022 requiring the consenting physician to perform the critical steps of the case, limiting surgeons to three cases per day, and mandating continuous, recorded ultrasound guidance for gluteal AFT procedures. References Garcia SE. Butt Lifts Are Booming.

Emergency Department 52

Emergency Department Operations Ultrasounds Hospitals 52

Taming the SRU

FEBRUARY 5, 2024

It is most helpful to do the ultrasound immediately before needle insertion, as movement of the patient may shift cutaneous landmarks from underlying bony structures. This resource offers additional information on ultrasound assisted LP’s. WHY - Why Not? REFERENCES 1. Zambito Marsala, S., Gioulis, M., & Pistacchi, M. Cabellos, C.,

Infectious Diseases 86

Infectious Diseases Seizures Ultrasounds Sepsis 86

PulmCCM

MARCH 1, 2022

The core of the conference is, no doubt, ultrasound, especially because Philippe has been at the forefront of point of care ultrasound in the intensive care unit. Therefore, there will be much ultrasound learning during hands-on workshops, in addition to the large library of digital offerings to supplement the face-to-face component.

Ultrasounds 40

Ultrasounds Resuscitation Sepsis 40

ACEP Now

MAY 4, 2023

Diagnosis: Complex Hydrocele (Pyocele) The testicular ultrasound revealed a small left complex hydrocele suspicious for pyocele. Early treatment with broad-spectrum antibiotics is essential to prevent sepsis and preserve testicular function. There were no rashes, discharge, or palpable inguinal hernias. Click to enlarge.)

Urgent Care 52

Urgent Care Ultrasounds Sepsis Emergency Department 52

Mind The Bleep

AUGUST 5, 2023

Common signs and symptoms include: Abdominal distention with prominent veins and discolouration Umbilical flaring Poor feeding Bilious vomiting Abdominal tenderness Bowel changes, including diarrhoea, blood and mucus Lethargy, apnoea, bradycardia Sepsis Risk factors of low birth rate, prematurity and formula feeding. (1, Updated 2022 Aug 8].

Sepsis 52

Sepsis Ultrasounds Radiology Radiology 52

PulmCCM

JULY 10, 2023

Continuous meropenem infusion for critically ill patients with sepsis Antibiotics have a time-dependent effect on bacteria; maintaining bacteriocidal concentrations of antibiotics should help subdue infections better than intermittent dosing. Mortality was about 30% in each group, and most patients had hospital-acquired sepsis.

Stroke 52

Stroke Sepsis Infectious Diseases Outcomes 52

EM Curious

JULY 29, 2015

NO RESPECT FOR THE RIGHT VENTRICLE [PODCAST]: The boys from Ultrasound Podcast sit down with critical care guru, Dr. Haney Mallemat, to discuss the assessment of the right ventricle with ultrasound. S-E-P-S-I-S A SEPSIS SMACC-BACK [PODCAST]: If you were at SMACC 2015 you may have been confused after the sepsis expert panel discussion.

Sepsis 52

Sepsis EMS Emergency Department Ultrasounds 52

University of Maryland CC Project

OCTOBER 5, 2021

Mallia, Assistant Professor of Emergency Medicine and Associate Program Director of the Pulmonary and Emergency Medicine-Critical Care Fellowship at MedStar Washington Hospital presents on critical care ultrasound for the assessment of the LV and RV as part of the DC5 lecture series. Dr. Anantha K.

Ultrasounds 40

Ultrasounds Hospitals Sepsis 40

Emergency Medicine Ireland

OCTOBER 28, 2020

This has relevance to the ICU population in 2 major ares * Sepsis. * EF does not correlate with particularly well with mortality in sepsis though diastolic dysfunction does * It may be due to under filling and the reduced diastolic filling due to the ubiquitous tachycardia in sepsis.

Sepsis 40

Sepsis Documentation/Coding Ultrasounds Wellness 40

EM Curious

JULY 8, 2015

ULTRASOUND GOODIE BAG ULTRASOUND FOR LATE PREGNANCY [PODCAST]: While not a routine exam we perform other than confirming fetal heart tones, definitely some great pearls on more advanced US topic. Consider an ultrasound guided ulnar nerve block. Part 1 here. US GUIDED ULNAR NERVE BLOCK [BLOG]: Boxer's fracture need a reduction?

Infectious Diseases 52

Infectious Diseases Disaster Management Sepsis Ultrasounds 52

EMDocs

JULY 29, 2023

Transoral Ultrasound in the Diagnosis of Obstructive Salivary Gland Pathologies. Ultrasound Med Biol. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Other bacterial causes include anaerobic oral flora, Strep viridans, E. Acute bacterial sialadenitis: a study of 29 cases and review. Rev Infect Dis.

EMS 69

EMS Dehydration Ultrasounds Emergency Department 69

Critical Care Now

APRIL 26, 2022

His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. Reading Time: 3 minutes Mohamed Hagahmed, MD, EMT-P Mohamed is an Emergency Medicine Physician and EMS director. A reduced supply of cortisol will decrease vascular tone, causing systemic vasodilation, shock, and hemodynamic collapse.

Resuscitation 52

Resuscitation Fluid Resuscitation EMS Sepsis 52

The Skeptics' Guide to EM

JANUARY 25, 2020

His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Case: A 60-year-old male is in your emergency department with sepsis from pneumonia.

Airway Management 40

Airway Management EMS Administration Resuscitation 40

Don't Forget the Bubbles

MAY 8, 2024

Use of neonatal lung ultrasound in European neonatal units: a survey by the European Society of Paediatric Research. 2024 Apr 3:114037 Apnea, Intermittent Hypoxemia, and Bradycardia Events Predict Late-Onset Sepsis in Infants Born Extremely Preterm. Shah M, et al. 2024 Apr 12:114054. Alonso-Ojembarrena A, et al. Marinelli T, et al.

Pediatrics 69

Pediatrics Emergency Department Outcomes Research 69

EMDocs

MAY 11, 2024

Cavernous sinus syndrome (B) usually presents with cranial nerve deficits, diplopia, periorbital cellulitis, and facial swelling that may progress to meningitis or sepsis. Semin Ultrasound CT MR. 2013 Apr;34(2):131-41. anatomic region). Brainstem stroke: anatomy, clinical and radiological findings. doi: 10.1053/j.sult.2013.01.004.

Stroke 79

Stroke EMS EKG/ECG Radiology 79

PEMBlog

JANUARY 17, 2024

Full blown sepsis and toxic shock syndrome. If you think that there’s an abscess, you can diagnose it clinically by a localized area of induration or fluctuance or use an ultrasound. You’re concerned about SIRS or sepsis. Bilateral red limbs? That’s probably something different. Fortunately, those are rare.

Infectious Diseases 59

Infectious Diseases Sepsis Wellness Pediatrics 59

Don't Forget the Bubbles

MARCH 4, 2024

Reviewed by: John Coveney Article 2: How do we define sepsis in children? International Consensus Criteria for Pediatric Sepsis and Septic Shock. The aim of this paper was to update and evaluate the criteria for sepsis and septic shock in children. It doesn’t help to diagnose or exclude sepsis. doi:10.1001/jama.2024.0179

Hospitals 78

Hospitals Sepsis Fractures Emergency Department 78

Emergency Medicine Ireland

DECEMBER 24, 2020

The pathophys is challenging to study but one animal model we do have suggested renal blood flow actually increases initially with the hyperdynamic state of sepsis without histological signs of injury. Excluding obstruction in AKI with some imaging like an ultrasound is a common recommendation but incredibly low yield.

Sepsis 40

Sepsis Ultrasounds EMS Hospitals 40

Dr. Smith's ECG Blog

OCTOBER 26, 2010

More often, tachycardia with ST segment abnormalities (elevation or depression) is due to an underlying illness (PE, sepsis, hemorrhage, dehydration, hypoxia, respiratory failure, etc.). The patient was suffering from severe dehydration, possibly with sepsis. Furthermore, notice the well-formed Q-waves in inferior leads. Cr was 13.4.

EKG/ECG 52

EKG/ECG Dehydration Fluid Resuscitation Sepsis 52

Pediatric Emergency Playbook

JUNE 1, 2016

Cardiogenic Shock: Act Use point-of-care cardiac ultrasound : Good Squeeze? It’s seen easily enough on point of care ultrasound. Tamponade: if any sign of shock, pericardiocentesis, preferentially ultrasound-guided. Children with sepsis come in two varieties: warm shock and cold shock. Pericardial Effusion? Pediatrics.

Shock 40

Shock Sepsis Pediatrics Ultrasounds 40

Northwestern EM Blog

FEBRUARY 14, 2022

This data shows us that angiotensin II can make the blood pressure better but I would never let it distract you from the things we know matter in sepsis resuscitation. But what does that mean to us clinically in the ED and ICU?

Shock 52

Shock Resuscitation Outcomes Fluid Resuscitation 52

EB Medicine

JUNE 6, 2019

CT is good but you really should learn ultrasound, and lastly, sick patients need prompt consultation and resuscitation, not rapid trips to radiology. Nachi: Diagnosis of appendicitis, in a pregnant patient, ultrasound vs. mri. was sensitive for 28-day mortality in sepsis. Jeff: Indeed. Sounds familiar. Jeff: We sure did!

Ultrasounds 40

Ultrasounds Radiology Radiology Sepsis 40

EM Curious

JULY 15, 2015

Onto the Foamed AIRWAY MANAGEMENT IN THE CRITICALLY ILL [PAPER]: If you intubate patients this is a must read for management of the airway of sick patients. Check it out here at Critical Care Horizons, a relatively new free online peer reviewed journal.

Airway Management 52

Airway Management EMS Poisoning Emergency Department 52

Don't Forget the Bubbles

FEBRUARY 5, 2024

Role of diagnostic tests for sepsis in children: a review. Assessing fluid responsiveness with ultrasound in the neonatal intensive care setting: the mini-fluid challenge. Addressing common questions on food oral immunotherapy: a practical guide for paediatricians. Anagnostou A, et al. Arch Dis Child. Rodgers O, et al. Arch Dis Child.

Pediatrics 52

Pediatrics Research Resuscitation Outcomes 52

EB Medicine

JULY 8, 2019

Leakage from the staple line typically presents within the first week, but can present up to 35 days, usually with fevers, tachycardia, abdominal pain, nausea, vomiting sepsis, or peritonitis. Some may present with isolated tachycardia while others may present with profound sepsis – tachycardia, hypotension, and fever. At 6 to 8 mL/kg.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

Mind The Bleep

DECEMBER 31, 2023

These require swabs, antibiotics, potentially a sepsis screen and bleeping your registrar / consultant for further advice. Anything infective sounding (fevers, redness at dialysis line exit site, rigors on dialysis etc) could be a sign of a dialysis line infection. In certain circumstances (e.g.

Fluid Resuscitation 52

Fluid Resuscitation Hospitals Sepsis EKG/ECG 52

RebelEM

FEBRUARY 19, 2024

The 2021 Surviving Sepsis Campaign Guidelines suggest starting vasopressors peripherally rather than delaying infusion until a CVC is placed [2]. of cases) Catheter ultrasound confirmation: 49.8% (i.e. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Not met in 16.7%

Administration 122

Administration Sepsis EMS Shock 122

Taming the SRU

MAY 1, 2023

Decreases penetration into tissue Increases excretion in urine Hemodialysis Role Clears ethylene glycol Clears toxic metabolites Indications A cidosis E lectrolytes I ngestion O verload U remia Vitamin therapy Helps with the clearance of toxic metabolites Thiamine Pyridoxine R1 CLinical DIAGNOSTICS: Toxic Plants WITH Dr.

Poisoning 52

Poisoning Hyperthermia / Hypothermia Emergency Department Seizures 52

Dr. Smith's ECG Blog

MAY 19, 2020

The ways to tell for certain include intravascular ultrasound (to look for extra-luminal plaque with rupture) or "optical coherence tomography," something I am entirely unfamiliar with. pulmonary embolism, sepsis, etc.), The diagnosis of MINOCA should exclude: 1) other overt causes for elevated troponin (e.g., myocarditis).

CPR 52

CPR EKG/ECG Shock Ultrasounds 52

Taming the SRU

AUGUST 30, 2023

Notably, lung ultrasound for the diagnosis of bacterial CAP demonstrated exceptional stand-alone diagnostic accuracy in 33 studies including 4,901 adults and children in the emergency department, with a pooled sensitivity of 92% and specificity of 90%. High serum procalcitonin concentrations in patients with sepsis and infection.

Infectious Diseases 78

Infectious Diseases Sepsis Emergency Department Point-of-Care Testing 78