Little Patients, Big Medicine Podcast: Lactate in Pediatric Sepsis

The first recording from Little Patients, Big Medicine: the Pediatric Emergency Medicine (PEM) Podcast. This is an exciting interview with Dr. Halden Scott, a PEM physician at Children’s Hospital Colorado, about the use of lactate measurement in pediatric sepsis. Dr. Scott is one of the premier pediatric sepsis researchers, with a specific focus on the use of lactate measurement in the ED. We talk about the Sepsis-3 definitions and whether pediatrics will eventually follow them, Dr. Scott’s previous work on lactate use in the pediatric ED, and her new article published in March of 2017 on the association between elevated lactate in the ED and 30-day mortality in children. ^1–6
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By Jason Woods, MD|2017-06-30T05:59:23-07:00Jun 7, 2017|Infectious Disease, Pediatrics|

PEM Pearls: Pediatric Sepsis Management – Understanding the Basics

Just as in adults, pediatric sepsis is a complex topic with continued research. In the United States, there are an estimated 75,000 cases per year of pediatric severe sepsis with an in-hospital mortality of 5-10%.^1,2 This is one of the deadliest conditions treated in children. In addition, after the Rory Staunton case, New York State passed regulations requiring all hospitals to have pediatric specific recognition, treatment, and data reporting systems. Several other states have adopted, or are considering, similar requirements. Thus it is critical that emergency physicians understand at least the basics of pediatric sepsis management.

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By Jason Woods, MD|2017-10-26T14:33:06-07:00Mar 1, 2017|Infectious Disease, Pediatrics, PEM Pearls|

AIR Series: Infectious Disease Module (2016)

Welcome to the Infectious Disease Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index the ALiEM AIR Team is proud to present the highest quality procedure content. Below we have listed our selection of the 18 highest quality blog posts within the past 12 months (as of August 2016) related to Infectious Disease emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 2 AIRs and 16 Honorable Mentions. We recommend programs give 6 hours (about 20 minutes per article) of III credit for this module.

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By Andrew Grock, MD|2017-03-05T14:18:46-08:00Dec 1, 2016|Approved Instructional Resources (AIR series), Infectious Disease|

Ultrasound For The Win! – 63M with an Erythematous Abdomen #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this case series, we focus on a real clinical case where bedside ultrasound changed the management or aided in the diagnosis. In this case, a 63-year-old man presents with a painful, warm, and erythematous area of his abdomen.

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By Jeffrey Shih, MD, RDMS|2017-07-19T00:06:42-07:00Jun 20, 2016|Infectious Disease, Ultrasound, Ultrasound for the Win|

Zika Virus: What emergency department providers need to know

The Zika virus outbreak has recently been put on “Level 1” activation status by the Emergency Operations Center at the U.S. Centers for Disease Control and Prevention (CDC). If you haven’t already thought about this affecting your emergency department, you should starting now. A Level 1 status has been triggered only 3 times in the recent years: Ebola (2014), H1N1 (2009), Hurricane Katrina (2005). The following are some key facts and resources.

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By Lauren Pike, MD|2018-10-28T21:27:16-07:00Feb 15, 2016|Expert Peer Reviewed (Clinical), Infectious Disease|

60-Second Soapbox: New podcast series featuring Drs. Lin, Riddell, Shaikh

We are excited to announce our new podcast series, 60-Second Soapbox! Each episode, one lucky individual gets exactly 1 whole minute to present their rant-of-choice to the world. Any topic is on the table – clinical, academic, economic, or whatever else may interest an EM-centric audience. Don’t worry if your are microphone-shy. We will carefully remix your audio to add an extra splash of drama and excitement. Even more exciting, participants get to challenge 3 of their peers to stand on a soapbox of their own!

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By Sam Shaikh, DO|2020-04-20T19:40:02-07:00Jul 29, 2015|60-Second Soapbox, Genitourinary, Infectious Disease, Medical Education, Podcasts, Trauma|

Blast From the Past: Occult Sepsis, Lactic Acid, and Mortality

Severe sepsis and septic shock affect millions of patients worldwide and have high rates of morbidity and mortality as well as high resource utilization. The way we manage sepsis has changed quite a bit since the Rivers et al randomized controlled trial of early goal-directed therapy (EGDT) ¹ , which had an absolute decrease in mortality from 46% with “usual care” to 31% with EGDT. What we now know is that a proactive approach to septic patients will result in lower mortality rates and better outcomes (i.e. early identification, early intravenous fluids, and early antibiotics). Patients with sepsis are still missed despite the fact that we understand the benefits to morbidity and mortality with early recognition. In this blast from the past study from 2007, Howell et al ² answered the important question of does elevated lactic acid simply reflect a patient’s hemodynamic status or can it independently predict 28 day in-hospital mortality after controlling for other potential confounders in patients with sepsis. (more…)

By Salim Rezaie, MD|2016-11-11T19:37:14-08:00Jun 29, 2015|Critical Care/ Resus, Expert Peer Reviewed (Clinical), Infectious Disease|

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