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Specialty: Emergency Medicine
Condition: Septic Shock

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Total 24 results found since Jan 2013.

Established evidence-based treatment guidelines help mitigate disparities in quality of emergency care.
CONCLUSIONS: Long-standing, nationally reported evidence-based guidelines can help eliminate sex and race/ethnicity disparities in quality of care. When providers know their care is being monitored and reported, their implicit biases may be less likely to impact care. PMID: 33599040 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - February 18, 2021 Category: Emergency Medicine Authors: Trent SA, George N, Havranek EP, Ginde AA, Haukoos JS Tags: Acad Emerg Med Source Type: research

Approaches in Prehospital Sepsis Screening
Discussion In the United States, sepsis is one of the leading causes of death, which requires timely identification and proper treatment (CDC, 2019; Guerra et al., 2020; Polito et al., 2015). Based upon a review of literature conducted from 2014 to 2018, the primary investigators could locate five prehospital EMS screening tools to assist EMS providers in identifying at-risk sepsis patients. The researchers explored how the modified SIRS and qSOFA scoring systems were used in hospital settings in addition to these five prehospital EMS screening tools. The Bas 90-30-90, Guerra, PRESEP, PRESS, and Robson tools have ove...
Source: JEMS Operations - January 5, 2021 Category: Emergency Medicine Authors: JEMS Staff Tags: Exclusives Patient Care EMS EMT Paramedic Prehospital Sepsis Source Type: news

Fluid Response Evaluation in Sepsis Hypotension and Shock
Patients in septic shock routinely receive large volumes of intravenous fluids as part of their initial resuscitation. However, hypervolemia secondary to aggressive fluid administration is associated with increased morbidity and mortality including renal failure, respiratory failure, or death. Dynamic approaches to hemodynamic monitoring for fluid responsiveness (FR) including measurement of stroke volume (SV) following increased fluid volume through IV fluids during passive leg raise (PLR) may have a role in guiding resuscitative efforts, although the benefits in an emergency department or ICU setting are unclear.
Source: The Journal of Emergency Medicine - January 1, 2021 Category: Emergency Medicine Authors: Benjamin Robert Wagner, Zachary B. Lewis Tags: Abstract Source Type: research

Studying the Clinical Data of COVID Positive patients admitted to a tertiary care academic hospital
Conclusion: The most common presenting symptoms included fever, cough, and shortness of breath. Patients who required ICU admission at presentation had a worse prognosis. Those with greater severity of symptoms were mainly elderly patients among which the most common comorbidity was hypertention followed by cardiac disease.
Source: Journal of Emergencies, Trauma and Shock - June 9, 2020 Category: Emergency Medicine Authors: Julio Arrieta Sagar Galwankar Natalia Lattanzio Darrel Ray Amit Agrawal Source Type: research

Beyond Triage and Resuscitation: Optimizing Care for the Critically Ill Emergency Department Patient
During my last shift in the emergency department (ED), I assumed care at sign-out of an intubated patient with an acute asthma exacerbation as well as a patient with cardiogenic pulmonary edema who was receiving noninvasive ventilation. Shortly thereafter, prehospital personnel brought us a patient with respiratory failure due to emphysema who needed to be intubated, followed by a patient having an acute stroke who would receive thrombolytics, followed by a patient with hypotension who would later require pressors for septic shock.
Source: Emergency Medicine Clinics of North America - June 29, 2019 Category: Emergency Medicine Authors: Amal Mattu Tags: Foreword Source Type: research

Evaluation of Vasopressin for Vasoplegic Shock in Patients With Preoperative Left Ventricular Dysfunction After Cardiac Surgery: A Propensity-Score Analysis
Conclusions: Compared with norepinephrine, vasopressin could not improve the postoperative outcomes in patients with pLVD after cardiac surgery. Vasopressin should be cautious to be used as a first-line vasopressor agent in postcardiac vasoplegic shock.
Source: Shock - October 16, 2018 Category: Emergency Medicine Tags: Clinical Science Aspects Source Type: research

Transporting Patients to Appropriate Receiving Destinations
Conclusion EMS is in a position to be the initiator of specialty center destination. In large cities with multiple hospitals, EMS should transport patients to the closest, most appropriate facility based on patient condition, even if this requires passing a closer facility. Where there are hospitals with multiple specialty services, EMS may be asked to activate a specific team, such as the stroke or cardiac team. In rural communities, EMS can communicate with the local hospital and by letting the hospital know of patient condition, help start the interfacility transport process from the field....
Source: JEMS Special Topics - July 19, 2018 Category: Emergency Medicine Authors: Dennis Edgerly, MEd, EMT-P Tags: Exclusive Articles Columns Operations Source Type: news

Deadly Respiratory Distress Mimic
Conclusion It’s important for prehospital providers to be able to differentiate metabolic disturbances in the setting of respiratory distress and not be fooled into thinking tachypnea always has a respiratory cause. The physical exam and adjuncts such as end-tidal capnography can assist in the prehospital diagnosis. A COPD exacerbation generally presents as diminished lung sounds, wheezing on exhalation, and a prolonged expiratory phase. Here, a patient will attempt to compensate for the inflammation and mucus accumulation associated with the destruction and narrowing of peripheral airways and a subsequent lack of availa...
Source: JEMS Special Topics - July 17, 2018 Category: Emergency Medicine Authors: Brenton Faber, PhD, NRP Tags: Airway & Respiratory Exclusive Articles Patient Care Source Type: news

Should Hyperoxia Be Avoided During Sepsis? An Experimental Study in Ovine Peritonitis*
Conclusions: In this acute peritonitis model, hyperoxia induced during resuscitation provided better hemodynamics and peripheral microvascular flow and better preserved cerebral metabolism, renal function, and gas exchange. These observations are reassuring with recent concerns about excessive oxygen therapy in acute diseases.
Source: Critical Care Medicine - September 16, 2017 Category: Emergency Medicine Tags: Online Laboratory Investigations Source Type: research

South Carolina EMS Integrates In-Hospital Sepsis Care into Protocols
Medic 29 is dispatched to a college dorm for a female with chief complaint of lower abdominal and flank pain for the past five days. The dorm room appears clean and well kept. The patient appears to be a typical 18-year-old college student. She's lying on her bed and is responsive to verbal stimuli, hot to touch, and tachycardic with weak and thready radial pulses at 128. She reports painful urinating for the past 48 hours, general malaise, weakness and nausea. She appears to have labored respirations with a room air SpO2 reading of 95% and is hypotensive with a systolic blood pressure of 88 mmHg that remains low during tr...
Source: JEMS Patient Care - September 1, 2016 Category: Emergency Medicine Authors: Jason G. Walchok, NRP, FP-C Tags: Patient Care Source Type: news