Podcast 598: Sepsis, Round One

Podcast 598: Sepsis, Round One

Contributor: Aaron Lessen, MD

Educational Pearls:

  • Early antibiotics have been shown to improve outcomes in septic patients time after time
  • Emerging evidence challenges the concept of one-size-fits-all large fluid boluses for septic shock patients and fluid may worsen patients who have underlying sepsis-induced pulmonary capillary leak
  • Starting peripheral vasopressors early, and relaxing if fluid resuscitation is successful, is appearing to be a more appropriate strategy than fluids first, then vasopressors

References

CLASSIC Trial Group; Scandinavian Critical Care Trials Group. Restricting volumes of resuscitation fluid in adults with septic shock after initial management: the CLASSIC randomised, parallel-group, multicentre feasibility trial. Intensive Care Med. 2016 Nov;42(11):1695-1705. doi: 10.1007/s00134-016-4500-7. Epub 2016 Sep 30. PMID: 27686349.

Permpikul C, Tongyoo S, Viarasilpa T, Trainarongsakul T, Chakorn T, Udompanturak S. Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER). A Randomized Trial. Am J Respir Crit Care Med. 2019 May 1;199(9):1097-1105. doi: 10.1164/rccm.201806-1034OC. PMID: 30704260.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD



Jaksot(1146)

Podcast # 439 : Oops I did it again

Podcast # 439 : Oops I did it again

Author: Aaron Lessen, MD Educational Pearl: A double ingestion of a single pill is typically a benign event but several drug classes may cause problems A published review of 10 years of single medica...

22 Helmi 20192min

Podcast # 438 : tPA for Frostbite

Podcast # 438 : tPA for Frostbite

Author: Aaron Lessen, MD Educational Pearls: Several studies have shown administration of tPA can improve outcomes and reduce need for amputation tPA is considered in grade III and IV frostbite tPA...

22 Helmi 20192min

Podcast # 437 : Myasthenia Gravis

Podcast # 437 : Myasthenia Gravis

Podcast # 437 : Myasthenia Gravis Author: Gretchen Hinson, MD Educational Pearls: Myasthenia gravis (MG) is an antibody mediated autoimmune disorder against the acetylcholine receptors at the neuromu...

20 Helmi 20197min

Podcast # 436 : Epinephrine Autoinjectors

Podcast # 436 : Epinephrine Autoinjectors

Author: Charleen Gnisci, PharmD Educational Pearls: Between 2011 to 2016, Mylan increased EpiPen prices by 400% ($700 for 2 packs) AUVI-Q was recalled in 2012, which left the market share to the Ep...

18 Helmi 20192min

Podcast # 435 : UCL Injury

Podcast # 435 : UCL Injury

Author: Ryan Circh, MD Educational Pearls: Ulnar collateral ligament injury is often called gamekeeper's thumb or skier's thumb Can results from traumatic deviating the thumb radially (abduction) Poo...

15 Helmi 20192min

Podcast # 434 : TIA

Podcast # 434 : TIA

Author: Peter Bakes, MD Educational Pearl: Transient ischemic attack (TIA) is defined as neurologic symptoms that resolve in 24 hours with no new changes on head imaging Mimics include complex migr...

13 Helmi 20195min

Podcast # 433: Geriatric Ketamine

Podcast # 433: Geriatric Ketamine

Author: Michael Hunt, MD Educational Pearls: Recent study compared ketamine to morphine in elderly patient Ketamine (IV dose 0.3 mg /kg) provided equivalent pain control to morphine (IV dose 0.1 mg ...

9 Helmi 20192min

Podcast # 432: Hunting for UTIs

Podcast # 432: Hunting for UTIs

Author: Michael Hunt, MD Educational Pearls: As many as 20% of women in assisted living have asymptomatic bacteriuria This can present a diagnostic conundrum when seeing these patients in the emergen...

7 Helmi 20193min

Suosittua kategoriassa Tiede

rss-poliisin-mieli
rss-mita-tulisi-tietaa
tiedekulma-podcast
docemilia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-duodecim-lehti
radio-antro
utelias-mieli
filocast-filosofian-perusteet
rss-lapsuuden-rakentajat-podcast
rss-lihavuudesta-podcast
rss-sosiopodi