Diastolic Shock Index: A clinically relevant predictor of poor outcome in septic shock?

Diastolic Shock Index: A clinically relevant predictor of poor outcome in septic shock?

Early recognition and resuscitation of patients in septic shock are critical skills for an emergency medicine physician. Many clinical decision-making tools have been developed and validated in their use to identify and define those who are in sepsis or septic shock, as well as predict a patient’s overall risk of morbidity and mortality, including tools like the SIRS criteria and SOFA score. The diastolic blood pressure is determined by vascular tone, and thus it can be assumed that a decrease in the diastolic blood pressure should correlate with the pathologic vasodilation in septic shock. As a result, the authors of this study hypothesized that the relationship between heart rate and the diastolic blood pressure (i.e. the diastolic shock index) could provide providers a tool to quickly identify patients that are at risk for unfavorable outcomes.

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Grand Rounds Recap 11.17.21

Grand Rounds Recap 11.17.21

Join us for our last grand rounds before Thanksgiving as Drs. Finney and Diaz discuss AKI management in the ED, Dr. Gobble discusses blunt cardiac injuries, Dr. Gawron tells the story of a young man presenting with a STEMI, and Drs. Connelly and Lane give us pointers on taking care of patients in the air.

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Grand Rounds Recap 11.20.19

Grand Rounds Recap 11.20.19

Dr. Golden kicked grand rounds off this week with our monthly morbidity and mortality conference, followed by Dr. Lane’s deep dive on massive pulmonary embolism in cardiac arrest and how to approach this. Dr. Owens then gave us a detailed review on a probably-more-common-than-you-think parasite that has started popping up in the US, and our excellent ED pharmacists gave us a crash course on common antidotes to various poisonings, overdoses, and bites that we frequently see in the ED. Finally, Dr. Ham finished up with a review of the importance of chronic hypertension in our ED population and how we can make a difference especially those with limited access to care.

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Grand Rounds Recap 8.22.18

Grand Rounds Recap 8.22.18

The week started off with our AirCare team discussing indications for procedures performed pre-hospital. The AirCare team continued by taking us through several cases in our quarterly AirCare M&M. We then got some oral boards practice with Drs. McDonough and LaFollette. The day finished with a simulation led by Dr. Hill covering patients who wish to leave AMA as well as the terrifying lengthening QTc.

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