We have discussed the dangers of surrogate outcomes at length, but none are more evident to an Emergency Physician than the time-based metrics we are subjected to on a daily basis. The latest of these temporal surrogates forced upon us is the 3-hour bundle of care in patients presenting to the Emergency Department with symptoms concerning for sepsis. In a recent article … [Read more...]
EM Nerd-The Case of the Cryptic Truth
On the morning of January 1st, 2017 a number of proud South Carolinians woke up to find themselves no longer living in their former state of residence. Without moving from the beds in which they slept, they were all magically transported into the neighboring the state of North Carolina. Due to a border dispute which has been underway for more than 20 years, the state line which … [Read more...]
Podcast 169 – Sepsis 3.0 with Merv Singer
Sepsis-3.0 has been released!Please read the paper!Then read some of the amazing discussions from the FOAM community:Jeremy Faust and Lauren Westafer reveal the new sepsis definitions. Great links to pro/con discussion too by Natalie May and Richard Carden at St Elmyn’s. Justin Mandeville also summarises Sepsis 3.0 and uses the “rule of 2s” in his post from … [Read more...]
Early norepinephrine to stabilize MAP in septic shock
0 Introduction 0 With publication of the PROCESS and ARISE trials, many hemodynamic goals are being disproven. There is a growing tide of nihilism. Should we should just give septic patients a couple bags of fluid, some antibiotics, and hope for the best? 0 Probably not. PROCESS and ARISE have showed us what we can ignore. Now it's time to focus on hemodynamic … [Read more...]
EMCrit Podcast 37 – Lactate in Sepsis
When an ED starts providing advanced care for severe sepsis, lactate testing is an absolute requirement. Lactate use brings up a lot of questions, especially if it is not commonly ordered in your department. In this podcast, I discuss all of the lactate questions that have come up in the course of the NYC Sepsis Collaborative.For the past few months, I have been co-chairing … [Read more...]
Hi, my name is Scott Weingart.