Validation and Clinical Implications of the IDSA/ATS Minor Criteria for Severe Community-Acquired Pneumonia

Validation and Clinical Implications of the IDSA/ATS Minor Criteria for Severe Community-Acquired Pneumonia

These findings support the use of the IDSA/ATS minor criteria to predict hospital mortality and guide ICU admission in inpatients with Community-Acquired Pneumonia (CAP) who do not require emergency mechanical ventilation... read more

Sepsis Guidelines Spark EM Petition

Sepsis Guidelines Spark EM Petition

It took all of one day for emergency physicians to organize opposition after an update to the Surviving Sepsis Campaign Bundle was released online. The day after the new version was released, Scott D. Weingart, MD, the editor-in-chief... read more

The Myth of Vasopressors and Ischemia

The Myth of Vasopressors and Ischemia

Despite the widespread clinical use, and their well-documented life-saving properties, vasopressors are often maligned, accused of causing ischemia to fingers, toes, mesentery, kidneys, and so forth. Not only is the evidence... read more

Pushing Pressors in the Periphery

The mantra of the Broome Docs site is "bringing great care, out there." And today's topic goes right to the heart of that theme. It is one of my pet topics – so apologies in advance if the rant is too long or detailed.... read more

Incidence of hypotension according to the discontinuation order of vasopressors in the management of septic shock

Incidence of hypotension according to the discontinuation order of vasopressors in the management of septic shock

Tapering NE rather than AVP may be associated with a higher incidence of hypotension in patients recovering from septic shock who are on concomitant NE and AVP. However, further studies with larger sample sizes are required... read more

Vasopressors for Hypotensive Shock

Vasopressors for Hypotensive Shock

This review seeks unbiased evidence about the effects of different drugs that enhance blood pressure on risk of dying in critically ill patients with impaired blood circulation. Review authors identified 28 randomized controlled... read more

Diagnostic Workup, Etiologies and Management of Acute Right Ventricular Failure

Diagnostic Workup, Etiologies and Management of Acute Right Ventricular Failure

Right Ventricular (RV) function evaluation is key in the critically-ill patients for hemodynamic management, as fluid optimization, vasopressor strategy and respiratory support. RV failure may be diagnosed by the association... read more

The Use of Bolus-Dose Vasopressors in the Emergency Department

The Use of Bolus-Dose Vasopressors in the Emergency Department

While bolus-dose vasopressors are commonly used in critical care medicine and anesthesiology to treat patients with hypoperfusion, its application in emergency medicine is minimal with little penetration into daily care.... read more

The Right Tool for the Right Patient

The Right Tool for the Right Patient

Resuscitative TEE in the diagnosis of massive PE in the ED. We have multiple tools in the ed that allow us to assess patients rapidly. But of course, you must use the right tool for the patient. transthoracic echo (TTE) can... read more

Decision-making in the detection and management of patients with sepsis in resource-limited settings

Decision-making in the detection and management of patients with sepsis in resource-limited settings

We read with interest the study by Andrews et al. and the related correspondence from Shrestha et al. We share the concern that clinical examination (and observations) appear(s) to be perceived as relatively unimportant in... read more

Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock

Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock

Targeting higher blood pressure targets may increase mortality in patients who have been treated with vasopressors for more than 6 h. Lower blood pressure targets were not associated with patient‑important adverse events... read more

Should We Manage All Septic Patients Based on a Single Definition?

Should We Manage All Septic Patients Based on a Single Definition?

It is indisputable from the biological and clinical perspectives that not all cases of sepsis are the same. On the contrary, most have great many differences, that is, different portals of entry, clinical manifestations,... read more

The EM Educator Series: Sepsis in the ED

The EM Educator Series: Sepsis in the ED

These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation... read more

Potentially Modifiable Risk Factors for Long-Term Cognitive Impairment After Critical Illness

Potentially Modifiable Risk Factors for Long-Term Cognitive Impairment After Critical Illness

Long-term cognitive impairment is common in survivors of critical illness. Little is known about the etiology of this serious complication. We sought to summarize current scientific knowledge about potentially modifiable... read more

FDA Approves Angiotensin-II for Septic Shock

FDA Approves Angiotensin-II for Septic Shock

The FDA approved angiotensin-II (Giapreza) as a new intravenous vasopressor for septic shock and other forms of distributive shock. The first new FDA-approved vasopressor in decades, angiotensin-II could significantly change... read more