Podcast #287: Sepsis Bundles

Podcast #287: Sepsis Bundles

Author: Aaron Lessen, M.D.

Educational Pearls

  • Treatment "bundles" are a popular approach to the rapid resuscitation of septic patients. A recent study in New York, where sepsis bundles are mandatory, sought to figure out which aspects of the bundle had impacts on mortality.
  • In a study of 40,000 septic patients, the study found that early antibiotics were associated with better outcomes, while early IV fluids were not associated with better outcomes.
  • This study affirms the important role of early antibiotics in sepsis. IV fluids may play an important role in the treatment of sepsis in some patients, but its role is less clear than antibiotics.

References: Time to Treatment and Mortality during Mandated Emergency Care for Sepsis Christopher W. Seymour, M.D., Foster Gesten, M.D., Hallie C. Prescott, M.D., Marcus E. Friedrich, M.D., Theodore J. Iwashyna, M.D., Ph.D., Gary S. Phillips, M.A.S., Stanley Lemeshow, Ph.D., Tiffany Osborn, M.D., M.P.H., Kathleen M. Terry, Ph.D., and Mitchell M. Levy, M.D. N Engl J Med 2017; 376:2235-2244 June 8, 2017 DOI: 10.1056/NEJMoa1703058

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Podcast # 350: Pressors and Ischemia

Podcast # 350: Pressors and Ischemia

Author: Nick Hatch, MD. Educational Pearls: A common concern using vasopressors is the risk of digital and mesenteric ischemia. The absolute risk of digital ischemia and/or mesenteric ischemia is...

9 Heinä 20183min

Podcast # 349: Fat Emboli

Podcast # 349: Fat Emboli

Author: Sue Chilton, MD Educational Pearls: Triad of fat emboli syndrome is a petechial rash, AMS, and respiratory distress. Petechiae usually start in the axilla. 90% of patients with long bon...

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Podcast # 348: Steakhouse Syndrome

Podcast # 348: Steakhouse Syndrome

Author: Don Stader, MD Educational Pearls: Steakhouse syndrome is an impacted esophageal food bolus. Occurs because they have an esophageal stricture (schatzki ring, scarring, esophagitis). Cla...

2 Heinä 20183min

Podcast # 347: Fasting and Procedural Sedation

Podcast # 347: Fasting and Procedural Sedation

Author: Sam Killian, MD Educational Pearls: Recent study examining fasting and adverse events during procedural sedation found no association between fasting duration and any type of adverse event....

29 Kesä 20183min

Podcast # 346: Pediatric DKA

Podcast # 346: Pediatric DKA

Author: Chris Holmes, MD Educational Pearls: There is a risk of cerebral edema in pediatrics with DKA if over resuscitated. Recent study comparing normal saline vs. ½ normal saline showed no diff...

27 Kesä 20184min

Podcast # 345: Epidural Abscess

Podcast # 345: Epidural Abscess

Author: Sue Chilton, MD Educational Pearls: IV drug use and spinal procedures are major risk factors. Classic triad of back pain, focal neurological deficit and fever. However, presence of fever ...

25 Kesä 20184min

Podcast # 344: Foley troubleshooting

Podcast # 344: Foley troubleshooting

Author: Aaron Lessen, MD. Educational Pearls: When foley is stuck, balloon may not have deflated. Make sure balloon is not in the urethra, which can block drainage. Cut off the port as it may b...

22 Kesä 20183min

Podcast # 343: Snake Bites

Podcast # 343: Snake Bites

Educational Pearls: Snake bites commonly occur between April and October. Rattlesnake bites are the most common. Venom contains proteins/enzymes that cause local inflammation, coagulopathy, and...

20 Kesä 20186min

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