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 #310: Bicarb in DKA

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Author: Gretchen Hinson, M.D. Educational Pearls: Controversial topic. Pathophysiology - acidosis leads to an extracellular potassium shift. Patients in DKA will be intracellularly potassium deplete,...

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Podcast #309: Return Visits to the ED for UTI

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Author: Alicia Oberle, MD Educational Pearls: Recent study has shown risk factors for return included patients at high risk for resistance (nursing home, obstructive uropathy), patient where diagno...

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Podcast #308: Ultrasound in Cardiac Arrest

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Author: Aaron Lessen, M.D. Educational Pearls: There is currently debate within the medical community about what constitutes cardiac activity on ultrasound in the setting of cardiac arrest. A recent ...

21 Mars 20182min

Podcast #307: Guillain-Barre Syndrome

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Author: Peter Bakes, M.D. Educational Pearls: Rare disease with 1-2 patients out of 100,000. About 60% of patients report a preceding diarrheal illness and classically presents with an ascending mo...

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Podcast #306: Tramadol Drama

Podcast #306: Tramadol Drama

Author: Nick Hatch, M.D. Educational Pearls Tramadol acts at multiple receptors and is a partial agonist at the mu opioid receptor, but also blocks reuptake of serotonin and norepinephrine throughou...

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Podcast #305: Stuffers vs. Packers : Drug-Packet Ingestion

Podcast #305: Stuffers vs. Packers : Drug-Packet Ingestion

Author: Aaron Lessen, M.D. Educational Pearls A "stuffer" is a term for someone who hastily and conceals a bag of drugs orally/rectally/vaginally in an unplanned situation. A "packer" is someone who...

14 Mars 20183min

Podcast #304: Nostalgia

Podcast #304: Nostalgia

Author: Dylan Luyten, MD Educational Pearls Johannes Hoffer coined term Nostalgia in 1688 in his medical dissertation. Nostalgia was a formal medical diagnosis, and one that dates back to 17th...

12 Mars 20185min

Podcast #303: Lazarus Effect

Podcast #303: Lazarus Effect

Author: Dylan Luyten, M.D. Educational Pearls The Lazarus phenomenon is the delayed return of spontaneous circulation after cessation of CPR. A prospective study in Finland found 5 out of 840 patient...

9 Mars 20183min

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