Podcast # 465: As easy and 1, 2, 10 - Capillary Refill and Sepsis

Podcast # 465: As easy and 1, 2, 10 - Capillary Refill and Sepsis

Author: Ryan Circh, MD

Educational Pearls:

  • The 2019 ANDROMEDA-SHOCK trial compared using serum lactates to capillary refill assessment in septic shock patients to guide resuscitation
  • Capillary refill time was standardized (this is not straightforward):
    • A glass microscope slide was pressed on the ventral side of the right index finger
    • Pressure was increased until the skin was blanched
    • This pressure was sustained for another 10 seconds
    • After pressure was removed, the time to return to normal skin color was timed
    • Greater than three seconds was considered abnormal.
  • No difference between the two groups for mortality at 28-days

Editor's note: lactates have become so ingrained in our practice it will be tough to change habits but this is an excellent quiver for those of us that hate the over reliance on this lab value alone, despite some of the limitations of the study.

References

Hernández G, Ospina-Tascón GA, Damiani LP, et al. Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA. 2019;321(7):654–664. doi:10.1001/jama.2019.0071

Summarized by Will Dewispelaere, MS3 | Edited by Erik Verzemnieks, MD



Avsnitt(1145)

Podcast 994: Biphasic Anaphylaxis

Podcast 994: Biphasic Anaphylaxis

Contributor: Aaron Lessen, MD Educational Pearls: What is anaphylaxis and what are its treatments?  Anaphylaxis is a broad term for potentially life threatening allergic reactions that can progress t...

16 Feb 3min

Podcast 993: Personalized Gene Editing Therapy

Podcast 993: Personalized Gene Editing Therapy

Contributor: Alec Coston, MD Educational Pearls: Disclaimer: this has nothing to do with the ER but is too cool to not talk about. Condition: Carbamoyl phosphate synthetase 1 (CPS1) deficiency Ra...

9 Feb 6min

Tox Talks 2025 Recap 2, Methemoglobinemia and Errors

Tox Talks 2025 Recap 2, Methemoglobinemia and Errors

Contributors: Travis Barlock MD, Ian Gillman PA, Jacob Altholz MD, Jeffrey Olson MS4 In this episode, EM attending Travis Barlock and medical student Jeffrey Olson listen in to the two remaining cases...

4 Feb 41min

Podcast 992: Fentanyl for Asthma

Podcast 992: Fentanyl for Asthma

Contributor: Alec Coston, MD Educational Pearls: BiPAP is often effective in severe asthma, but many patients struggle with mask tolerance due to intense air hunger–driven anxiety, often compounded ...

2 Feb 4min

Episode 991: BRASH

Episode 991: BRASH

Contributor: Aaron Lessen, MD Educational Pearls BRASH Syndrome: Bradycardia Renal Failure AV Nodal Blockade Shock Hyperkalemia  Clinical Features: Profound bradycardia and shock in pat...

19 Jan 2min

Episode 990: Tramadol, or rather, Trama-don't

Episode 990: Tramadol, or rather, Trama-don't

Contributor: Taylor Lynch, MD Educational Pearls: What is tramadol and how does it work? Tramadol is a Schedule IV opioid analgesic used for moderate pain and is often perceived as safer than other ...

12 Jan 5min

Episode 989: Young Strokes

Episode 989: Young Strokes

Contributor: Aaron Lessen, MD Educational Pearls: The Case 24F brought in for anxiety. Patient is tearful, not talking, and potentially hyperventilating. History from boyfriend is that she suddenly ...

5 Jan 3min

Episode 988: Infant Botulism

Episode 988: Infant Botulism

Contributor: Aaron Lessen, MD Educational Pearls: A 2025 multistate outbreak of infant botulism has been linked to ByHeart infant formula As of December 10-17th, there have been at least 51 infants ...

29 Dec 20252min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
pojkmottagningen
dumforklarat
rss-vetenskapsradion-2
halsorevolutionen
rss-vetenskapsradion
rss-ufo-bortom-rimligt-tvivel
sexet
rss-spraket
rss-experimentet
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
medicinvetarna
vetenskapsradion
rss-arkeologi-historia-podden-som-graver-i-vart-kulturlandskap
bildningspodden