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Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Acute Coronary Syndrome I: Introduction01:30

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Urine Studies II: Urine Culture and Sensitivity Test01:26

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A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
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Healthcare Associated Infections II: Preventive Measures01:22

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Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
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Acute Coronary Syndrome IV: Interprofessional Care01:28

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IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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Cardiac Catheterization IV: Nursing Management01:26

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Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
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Updated: Jul 25, 2025

Evaluation of a Reliable Biomarker in a Cecal Ligation and Puncture-Induced Mouse Model of Sepsis
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Do prehospital sepsis alerts decrease time to complete CMS sepsis measures?

Ruben Troncoso1, Eric M Garfinkel1, Jeremiah S Hinson1

  • 1Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD, United States of America.

The American Journal of Emergency Medicine
|June 24, 2023
PubMed
Summary
This summary is machine-generated.

Prehospital sepsis alerts did not significantly decrease the time to complete all four core sepsis measures. However, alerts did speed up lactate collection, blood cultures, and IV fluids, but not antibiotic administration.

Keywords:
Emergency medical servicesPrehospital alertSepsis

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Area of Science:

  • Emergency Medicine
  • Critical Care Medicine
  • Public Health

Background:

  • Sepsis management bundles, established by the Centers for Medicare and Medicaid Services (CMS), are crucial for improving patient outcomes.
  • These bundles include timely blood culture collection, serum lactate measurement, intravenous fluid administration, and broad-spectrum antibiotic initiation.
  • The impact of prehospital sepsis alert protocols on the completion time of these core measures remains under-investigated.

Purpose of the Study:

  • To evaluate the effectiveness of a prehospital sepsis alert protocol in reducing the time to complete CMS sepsis core measures.
  • To compare the time to completion of individual sepsis core measures between patients with and without a prehospital sepsis alert.

Main Methods:

  • A retrospective cohort study was conducted involving patients transported by Emergency Medical Services (EMS) between December 1, 2018, and December 1, 2019.
  • Patients meeting the Maryland Statewide EMS sepsis protocol criteria were compared based on whether a prehospital sepsis alert was activated.
  • The protocol criteria included suspected infection and at least two specific vital sign or lactate level abnormalities.

Main Results:

  • The median time to achieve all four CMS sepsis core measures was not significantly different between the alert (103 min) and non-alert (106.5 min) groups (p=0.105).
  • Median times were significantly shorter for serum lactate collection (28 vs. 35 min, p=0.019), blood culture collection (28 vs. 38 min, p<0.01), and IV fluid administration (54 vs. 61 min, p=0.025) in the alert group.
  • There was no significant difference in the median time for antibiotic administration between the groups (94 vs. 103 min, p=0.12).

Conclusions:

  • This study suggests that current prehospital sepsis alert protocols may not significantly decrease the overall time to complete all CMS sepsis core measures.
  • While alerts expedited certain components like lactate and blood cultures, antibiotic administration time was not significantly impacted.
  • Future research should explore interventions such as enabling EMS providers to administer antibiotics independently to further reduce sepsis care times.