Podcast 676: Spontaneous Bacterial Peritonitis

Podcast 676: Spontaneous Bacterial Peritonitis

Contributor: Sam Killian, MD

Educational Pearls:

  • Patients with cirrhosis and ascites are frequently evaluated for spontaneous bacterial peritonitis, an infection of the ascites fluid that is not from a surgically treated source
  • Fever, abdominal pain, and altered mental status should all raise clinical suspicion in a patient with ascites
  • Fluid from paracentesis may show increased WBCS (polys and neutrophils), high LDH, high amylase, and decreased glucose
  • Outcomes are very poor in these patients with 30-40% of these patients continue to renal failure with 60-80% in-hospital mortality
  • Typically treat with a third generation cephalosporin or ampicillin+gentamicin

References

Long B, Koyfman A. The emergency medicine evaluation and management of the patient with cirrhosis. Am J Emerg Med. 2018;36(4):689-698. doi:10.1016/j.ajem.2017.12.047

MacIntosh T. Emergency Management of Spontaneous Bacterial Peritonitis - A Clinical Review. Cureus. 2018;10(3):e2253. Published 2018 Mar 1. doi:10.7759/cureus.2253

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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Podcast 818: Local Anesthetics and LAST

Podcast 818: Local Anesthetics and LAST

Contributor: Don Stader, MD Educational Pearls: There are two major groups of local anesthetics: Amide and Esther To recall what group an anesthetic belongs to, use this memory trick: Amide has...

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Podcast 817: MI Risk during Elections

Podcast 817: MI Risk during Elections

Contributor: Aaron Lessen, MD Educational Pearls: 2020 retrospective study with dat from two California hospitals compared rates of cardiovascular admissions in a five day period two weeks before and...

3 Loka 20222min

Podcast 816: Ventilator Management in Asthmatics

Podcast 816: Ventilator Management in Asthmatics

Contributor: Aaron Lessen, MD Educational Pearls: The management of severe asthma or COPD exacerbation is complex, especially when the patient requires intubation/ventilation Asthma is an obstructive...

27 Syys 20224min

Podcast 815: Fluid Resuscitation in Pancreatitis

Podcast 815: Fluid Resuscitation in Pancreatitis

Contributor: Aaron Lessen, MD Educational Pearls: Historically, pancreatitis has been treated with aggressive IV fluid rehydration. Recently published data shows this may not be appropriate. A random...

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Podcast 814: Post-concussion Treatment

Podcast 814: Post-concussion Treatment

Contributor: Aaron Lessen, MD Educational Pearls: Recent study looked at the impact of screen time on duration of post-concussive symptoms 125 patients aged 12-25 diagnosed with a concussion were ran...

19 Syys 20222min

Podcast 813: Pulse Oximetry

Podcast 813: Pulse Oximetry

Contributor: Travis Barlock, MD Educational Pearls: Most oxygen in the body is bound to hemoglobin, forming oxyhemoglobin. Less than 1% of the oxygen in the body is dissolved in plasma.  Pulse Oximet...

13 Syys 20224min

Podcast 812: PO Medications

Podcast 812: PO Medications

Contributor: Nick Tsipis, MD Educational Pearls: PO medications are less frequently used in the ED due to their longer onset of action The position the patient is in when given PO medications ...

12 Syys 20223min

Podcast 811: Ketamine for Pain

Podcast 811: Ketamine for Pain

Contributor: Lessen, Aaron MD Educational Pearls: Ketamine can be given at 0.2-0.3 mg/kg as subdissociative doses for pain control in the ED Ketamine coadministered with Haldol may reduce agitation...

7 Syys 20223min

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