Author: Nicole Anthony, MD Peer Reviewer: Trevor Cerbini, MD In Part 1 of our 2-part series on hypoglycemia, Erroneous Blood Glucose Readings and Where To Find Them, we introduced the vignette of a patient in a shock state whose peripheral fingerstick reading would not respond to repeated dextrose administration. Now, Read more…
This article is reposted from The American Journal of Emergency Medicine. Introduction The coronavirus disease 2019 (COVID-19) pandemic has caused a total of nearly 300,000 deaths worldwide [1]. Pediatric patients PCR-postive for SARS-CoV-2 present differently than adults with 40% either asymptomatic or with URI symptoms and commonly have pharyngeal erythema Read more…
A 40-year-old male with a past medical history of paraplegia presents with four days of right thigh swelling. He initially noticed a small ulcer on his thigh and tried home treatments with alcohol swabs and peroxide rinses. He reports worsening swelling and pain from the area and also notes hematuria, Read more…
A 54-year-old male with history of alcohol abuse presents with right forearm pain and swelling following a fall two days ago. The pain is constant, sharp, “radio buzzing”, and 10/10. He also reports redness, swelling, and “feels cold”. He denies fevers, LOC, CP, SOB, weakness/numbness. Initial VS: HR 120/min, RR 20/min, Read more…
You are just getting over your third viral illness this winter. Your tummy will never forget this one, but on the bright side you lost 5 pounds nibbling on saltine crackers for a week. You drink some coffee and coconut water in a hurry and arrive energized to your shift Read more…
In 2015, the Centers for Medicare and Medicaid Services (CMS) adopted SEP-1, a controversial sepsis quality metric drawn from the Surviving Sepsis Campaign (SSC) guidelines. Extensive focus on guideline evidence, covered well elsewhere, leaves out the details surrounding the process of its implementation.1,2 This post will describe the process and Read more…
In 2001, the only drug to treat sepsis was approved by the FDA and swiftly brought to market by Eli Lilly & Co. So, why have most residents never heard of Xigris (drotrecogin alfa)? By Dr. Lee Grodin [1] Bloomberg News. Lilly Read more…
It’s a busy night shift when a nurse alerts you to an elderly patient sent from a nursing home who is hypotensive, tachycardic, tachypneic, febrile, altered, and appears dehydrated. You assume sepsis, send labs, begin treating empirically with broad spectrum antibiotics, and start fluid resuscitating the patient. Despite receiving 30cc/kg of normal Read more…
Presented by: Dr. Eris Cani / Summarized by: Dr. Sarah Jung / Reviewed by: Dr. Stanley Moy HAPPY 2016!!! Summary: Procalcitonin is a specific biomarker that can be useful for diagnosing bacterial infections Most evidence for PCT utilization is for patients with LRTI (rule-in or rule-out pneumonia) Read more…
What is it good for? Something? Maybe? Remember in medical school when the right answer to everything was cytokines. The mythical inflammatory response; all those interleukins, TNFs, and all other forms of molecular magic that drive our response to infection. The so-called “pyrogens,” or molecular agents causing fever, are Read more…