#FOAM

A great deal of literature exists on sepsis and providing state of the art care in the ED. As EM physicians, we pride ourselves on resuscitating sick patients, and we are well aware that septic patients can rapidly decline clinically. Finding the source and providing appropriate antibiotics, adequate preload with IV fluids, and vasopressors if necessary are key components. The SIRS criteria are our first line of defense in the early identification of sepsis. But, it is important to recognize that just because a patient has multiple SIRS criteria, they may not actually be septic.

Please see prior post here: http://www.emdocs.net/reversal-of-anticoagulation/

On October 16, 2015 the FDA granted accelerated approval of idarucizumab (Praxbind), a novel reversal agent of the direct thrombin inhibitor Dabigatran (Pradaxa), for utilization in life-threatening bleeding emergencies.1

All those eponyms. What does the emergency physician need to know for wrist and forearm fractures?

This is another great reason to discuss not throwing antibiotics at every kid with an ear.

You are in the midst of caring for a 62 year-old male who is tachycardic with HR 120, BP 88/42, T 101.2 oF, RR 26, and SpO2 98%. He was brought in by EMS for fever and myalgias, and with one look at his vital signs, he triggered the protocol for SIRS.

Your initial exam showed similar vital signs, with dry mucous membranes but otherwise normal HEENT exam, clear lungs, normal mental status, nontender abdomen, normal skin and genitourinary exams, and normal extremities/back. Due to his vital signs and SIRS criteria, you were concerned and ordered CBC, RFP, LFT, lactate, blood cultures, urinalysis/culture, and chest xray. You started 1 L NS, and his VS did not improve.

A few of the questions in your mind should at least be: what is most likely to kill this patient, do I need to get a CT of the head, does he need a lumbar puncture, does he need any urgent medications, and what labs should I order?

Continuous quantitative waveform capnography, also known as end-tidal carbon dioxide, PetCO2, or ETCO2, is a measurement of the partial pressure of CO2 in the exhaled breath. This technology has been around since the mid-19th century and only relatively recently has its potential in emergency medicine begun to be explored. […]

Sepsis is the most common cause of death in children worldwide. What is the optimal evaluation and management of pediatric sepsis?

We’re excited to announce our next AMA: Kevin Klauer will be with us TODAY: Tuesday, September 2nd, from 2-4pm CST.

Some background on Dr. Klauer from his bio page on emp.com:

• Chief Medical Officer of Emergency Medicine Physicians, one of the leading providers of emergency medical services in the nation
• Has received the ACEP National Faculty Teaching Award and the EMRA Robert J. Dougherty Teaching Fellowship Award
• He is the ACEP Council Vice Speaker and serves as Medical Editor-in-Chief for ACEP Now
• Co-author of two risk management books: Emergency Medicine Bouncebacks: Medical and Legal and Risk Management and the Emergency Department: Executive Leadership for Protecting Patients and Hospitals

Hope you can join us!