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SGEM#294: Blood Pressure – Do Better, Keep Rising with NorEpi

The Skeptics' Guide to EM

Max is then going to Georgetown to be an attending in both EM and ICU. You scan through the EMR and see the blood pressure is 60/40. Case: It’s another day in your emergency department (ED). Six hours into your shift, you finish dispo’ing the “really quick sign-out” from the night before.

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SGEM#346: Sepsis – You Were Always on My Mind

The Skeptics' Guide to EM

Despite the lack of high-quality evidence to support these sepsis bundles, many hospitals incorporated them into their electronic medical record (EMR). It is the leading cause of death in the intensive care unit (ICU) in the US and the most expensive diagnosis. Worldwide sepsis contributes to the death of 5.3

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New Clinical Practice Guideline Released

American Burn Association

.” This CPG will be of most use to nurses, physicians, and rehabilitation therapists who provide care to critically ill patients in the burn-ICU. It is conditionally recommended that early mobilization and rehabilitation (EMR) be considered in critically ill burn patients in the ICU to reduce ICUAW and delirium.

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Impact of Emergency Department Crowding on Lung Protective Ventilation

REBEL EM

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. 2019 Aug; PMID: 30954692 Clinical Question: What is the impact of system factors in the implementation of standard-of-care LPV in critically ill ED patients admitted to the ICU? Paper: Owyang CG, et al.

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The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

REBEL EM

The retrospective design of this study omitted assessment of ventricular dysrhythmias related to push dose pressor administration, as they were reliant on information in the EMR. The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. J Med Toxicol. Epub 2019 Jul 3. Intensive Care Med.

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The Brink of Burnout

AAEM RSA

We have already converted pediatric hospitals to accept adult patients, our backup docs are working full schedules, our nurses are working double time, the ED functions as an additional ICU, and we are stretched to our limits with no end in sight. The emotional toll that this is waging on many of us is very concerning.

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Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

REBEL EM

Reliance on a billing dataset, instead of EMR or prospective data, likely affected the quality of outcome measurement. This study only included data from the United States; it may not be generalizable to other countries where clinical practice and patient populations differ.

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