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(1149)

Episode 947: Hypercapnia

Episode 947: Hypercapnia

Educational Pearls: Physiologic stimulation of ventilation occurs through changes in levels of: Arterial carbon dioxide (PaCO2) Arterial oxygen (PaO2) Hypercapnia is an elevated level of CO2...

10 Mars 20253min

Episode 946: Time to Defibrillation

Episode 946: Time to Defibrillation

Contributor: Aaron Lessen, MD Educational Pearls: Quick background info Cardiac arrest is when the heart stops pumping blood for any reason. This is different from a heart attack in which the heart ...

3 Mars 20252min

Episode 945: Ketorolac vs. Ibuprofen

Episode 945: Ketorolac vs. Ibuprofen

Contributor: Ricky Dhaliwal, MD Educational Pearls:  Ketorolac and ibuprofen are NSAIDs with equivalent efficacy for pain in the emergency department Oral ibuprofen provides the same relief as in...

24 Feb 20253min

Episode 944: Colchicine Overdose

Episode 944: Colchicine Overdose

Contributor: Aaron Lessen, MD Educational Pearls: Colchicine is most commonly used for the prevention and treatment of gout There is research investigating the anti-inflammatory and cardioprotect...

17 Feb 20253min

Episode 943: Portal Vein Thrombosis

Episode 943: Portal Vein Thrombosis

Contributor: Travis Barlock, MD Educational Pearls: What is Portal Vein Thrombosis? The formation of a blood clot within the portal vein, which carries blood from the gastrointestinal tract, pancrea...

10 Feb 20252min

Episode 942: Acute Mountain Sickness and High Altitude Cerebral Edema

Episode 942: Acute Mountain Sickness and High Altitude Cerebral Edema

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Acute mountain sickness (AMS) is the term given to what is otherwise colloquially known as altitude sickness High altitude cerebral ed...

3 Feb 20253min

Episode 941: Rehydration in Pediatric Gastroenteritis

Episode 941: Rehydration in Pediatric Gastroenteritis

Contributor: Meghan Hurley, MD Educational Pearls: Gastroenteritis clinical diagnoses: Diarrhea with or without vomiting and fever Vomiting in the absence of diarrhea has a large list of diffe...

27 Jan 20253min

Episode 940: Laceration Repair Methods

Episode 940: Laceration Repair Methods

Contributor: Aaron Lessen, MD Educational Pearls: If a patient sustains a cut, the provider has several options on how to close the wound. If they choose to suture the wound closed, it involves need...

20 Jan 20252min

Populärt inom Vetenskap

dumma-manniskor
p3-dystopia
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
rss-vetenskapsradion-2
medicinvetarna
rss-ufo-bortom-rimligt-tvivel-2
rss-vetenskapsradion
det-morka-psyket
bildningspodden
sexet
paranormalt-med-caroline-giertz
halsorevolutionen
hacka-livet
rss-spraket
har-vi-akt-till-mars-an
dumforklarat
rss-geopodden-2
rss-experimentet