Factors and outcomes associated with under- and overdiagnosis of sepsis in the first hour of emergency department care.

Background: Sepsis remains the leading cause of in-hospital death and one of the costliest inpatient conditions in the United States, while treatment delays worsen outcomes. We sought to determine factors and outcomes associated with a missed emergency physician (EP) diagnosis of sepsis.

Methods: We conducted a secondary analysis of a prospective single-center observational cohort of undifferentiated, critically ill medical patients (September 2020-May 2022).

Cardiac arrest secondary to environmental hypothermia: Incidence and outcomes in an urban emergency department in the Upper Midwestern United States.

Objectives: Data describing hypothermic cardiac arrest (HCA) outcomes predominantly originate from patients involved in wilderness accidents. We describe the incidence and outcomes of HCA in an urban environment, with a subgroup analysis of patients with witnessed HCA in the prehospital or emergency department (ED) setting.

Methods: We completed a retrospective, single center cohort analysis of consecutive adult patients with environmental exposure and core body temperature ≤ 32 °C.

The Association of Lowest Prehospital Blood Pressure with Mortality in Severe Traumatic Brain Injury from a Nationwide Emergency Medical Services Database.

Objectives: Clinical management of traumatic brain injury (TBI) focuses on preventing secondary injury from cerebral edema and ongoing anoxic injury. Consensus guidelines recommend maintaining systolic blood pressure (SBP) 110 mmHg. A recent prehospital study suggested lowest adjusted mortality from 130 mmHg to 180 mmHg, suggesting the ideal pressure may be higher.

Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients.

Study Objective: Compare physician gestalt to existing screening tools for identifying sepsis in the initial minutes of presentation when time-sensitive treatments must be initiated.

Methods: This prospective observational study conducted with consecutive encounter sampling took place in the emergency department (ED) of an academic, urban, safety net hospital between September 2020 and May 2022. The study population included ED patients who were critically ill, excluding traumas, transfers, and self-evident diagnoses.

The Effect of Ketamine Versus Etomidate for Rapid Sequence Intubation on Maximum Sequential Organ Failure Assessment Score: A Randomized Clinical Trial.

Background: The use of induction agents for rapid sequence intubation (RSI) has been associated with hypotension in critically ill patients. Choice of induction agent may be important and the most commonly used agents are etomidate and ketamine.

Objective: This study aimed to compare the effects of a single dose of ketamine vs.

Subcortical brain segment volumes in Gulf War Illness and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Aims: There is controversy about brain volumes in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (CFS) and Gulf War Illness (GWI). Subcortical regions were assessed because of significant differences in blood oxygenation level dependent signals in the midbrain between these diseases.

Materials And Method: Magnetization-prepared rapid acquisition with gradient echo (MPRAGE) images from 3 Tesla structural magnetic resonance imaging scans from sedentary control (n = 34), CFS (n = 38) and GWI (n = 90) subjects were segmented in FreeSurfer.

Human Errors and Adverse Hemodynamic Events Related to "Push Dose Pressors" in the Emergency Department.

Background: Though the use of small bolus doses of vasopressors, termed "push dose pressors," has become common in emergency medicine, data examining this practice are scant. Push dose pressors frequently involve bedside dilution, which may result in errors and adverse events. The objective of this study was to assess for instances of human error and adverse hemodynamic events during push dose pressor use in the emergency department.