Sepsis resuscitation: Applying the Pathophysiology, Guidelines and future of sepsis care at the bedside.

Approach to Low Back Pain & Cauda Equina Syndrome in the ED

Mnemonic for BACKPAIN Red Flags & Do Not Miss DDX =BACKPAIN can be CRAFTI Back Pain Red Flags*   Bladder, Bowel & Erectile Dysfunction or Bilateral Sx**   Anaesthesia (saddle)   Cancer or Coagulopathy – Sx or PMH/risk (N.B. Thoracic Back Pain)   Kyphosis, stenosis, achondoplasia, or other pre-existingspinal narrowing.   Pain at Night +/-worse lying down think infection or cancer (USUALLY Discogenic pain is worse with flexion, & pain from spondylolysis is worse with extension)**   Age <20 or >50 = think harder about other causes.   IVDU/Immunocompromised/ recent Infection or Intervention(e.g. epidural), chronic steroids, sickle cell, organ failure, DM   Neurology (progressive & bilateral sensory or motor)**   *positive responses to “red flag’ questions for low backpain (e.g. bowel or bladder incontinence, history of cancer, trauma, fever, IV drug use etc) prompt further investigation, negative responses are not sufficient to rule out serious pathology.   ** Retrospective tertiary centre review (U.K.) showed thatbilateral lower extremity pain, dermatomal distribution sensory loss, & loss of bilateral ankle/knee reflexes showed correlation with radiographic diagnosis of cauda equina compression (CEC); while digital rectal examination(DRE) did not demonstrate any benefit. However, individual symptoms showed poor performance in ruling in (or out) CEC. For more on low back pain emergencies see EM CASES Episode 26.         CRAFTI DDx of low back pain to consider:   Compression (CAUDA EQUNIA Compression [CEC], ConusMedullaris, Epidural Haematoma / Cauda Equina) Renal Colic or other abdominal cause e.g. pancreatitis AAA or vascular Dissection Fracture (Trauma / Osteoporotic) Tumour (cancer 1ary or 2ary) Infection/Inflammation (Epidural Abscess, Osteomyelitis,Discitis, Transverse Myelitis)

Locating the Source of Sepsis: The LUCAS mnemonic

Clinical Epidemiology and Bedside Identification of Sepsis Sources in the United Kingdom: A Comprehensive Analysis of the Expanded LUCAS Framework and NHS Presentation Trends The clinical management of sepsis within the United Kingdom’s National Health Service (NHS) has undergone a paradigmatic shift over the last decade, transitioning from a reactive physiological response model to a proactive, source-centric diagnostic strategy. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, and it remains a primary driver of morbidity and mortality across all levels of secondary care.[1] Within the high-pressure environment of the Emergency Department (ED), the ability to rapidly identify the infectious focus is as critical as the initiation of early fluid resuscitation and antimicrobial therapy. The LUCAS mnemonic—traditionally Lungs, Urine, CNS, Abdomen, and Skin, but expanded here to include Spine, Septic joints, Septic emboli, and Endocarditis—serves as an essential cognitive aid for clinicians to systematically survey the most prevalent and high-risk anatomical origins of infection in a population increasingly characterized by frailty, multi-morbidity, and advanced age.[2, 3, 4]

Sepsis resuscitation: Applying the Pathophysiology, Guidelines and future of sepsis care at the bedside.

Sepsis is a time-critical medical emergency defined as life-threatening organ dysfunction caused by a dysregulated host response to infection [1]. Globally, it remains a leading cause of morbidity and mortality, with an estimated 49 million cases and 11 million deaths annually [8].

Mental SIM: HALO Procedure - Tracheostomy & Laryngectomy Emergency Mx Algorithm

What to do in these emergency situations.

Sepsis in pregnant or recent pregnant patients recognition, Diagnosis & Mx

Suspected Sepsis in Pregnant and Recently Pregnant People: Recognition, Diagnosis, and Early Management Executive Summary Sepsis in the obstetric population is a life-threatening medical emergency requiring immediate recognition and intervention. This guideline (NICE NG255, 2025) replaces NG51 and provides a tailored framework for pregnant people and those who have been pregnant within the last six weeks.Critical Takeaways: * The 6-Week Window: Always consider sepsis in any person who is pregnant or has been pregnant (including miscarriage or termination) within the previous six weeks. * High-Risk Criteria: Identify "High Risk" status immediately using the stratified criteria (e.g., RR ≥ 25, HR > 130, SBP ≤ 90, or altered mental state). * The 1-Hour Bundle: For high-risk patients, the senior clinical decision-maker must assess, and broad-spectrum antibiotics must be administered within one hour. * Source Control: Active search for the infection source (including imaging of the abdomen and pelvis) is mandatory if the source is not immediately apparent. * Senior Involvement: Specific clinician grades are defined for senior review (ST3+ for adults, ST4+ for under 18s).