Intro: Our objective was to compare the ability of SI, individual vital signs, and the systemic inflammatory response syndrome (SIRS) criteria to predict the primary outcome of hyperlactatemia (serum lactate ≥ 4.0 mmol/L) as a surrogate for disease severity, and the secondary outcome of 28-day mortality.
Conclusion: In this cohort, SI ≥ 0.7 performed as well as SIRS in NPV and was the most sensitive screening test for hyperlactatemia and 28-day mortality. SI ≥ 1.0 was the most specific predictor of both outcomes.
Introduction: We examined the accuracy and time-saving effect of a handheld Point-of-care (POC) device for the measurement of fingertip and whole blood lactate as compared with reference laboratory testing in critically ill ED patients.
Conclusion: Fingertip POC lactate measurement is an accurate method to determine lactate levels in infected ED patients with normal or modestly elevated lactate values and significantly decreases time to test results.
To alert emergency medicine practitioners that H influenzae should be recognized as a maternal, fetal, and neonatal pathogen. Clinicians should consider this diagnosis in immigrants presenting with uncertain vaccination history, as H influenzae can cause significant morbidity and mortality.
A 38-year-old woman with insulin-dependent diabetes reported four-days of flank pain, dysuria, polyuria and urinary urgency. Vital signs included blood pressure 113/70mmHg, heart rate 135/min, respiratory rate 24/min, and temperature 102.5°F. Exam revealed right cerebral vascular accident and suprapubic tenderness without guarding or rebound.
To determine if a sensitive D-dimer assay can exclude progression to organ dysfunction, death, and intensive care unit (ICU) admission in patients presenting to the emergency department (ED) with suspected infection, and if increasing levels of D-dimer are predictive of those end points.
Despite its widespread use in North America and many other parts of the world, the safety of etomidate as an induction agent for rapid sequence intubation in septic patients is still debated. In this article, we evaluate the current literature on etomidate, review its clinical history, and discuss the controversy regarding its use, especially in sepsis. We address eight questions
