procalcitonin

In this episode, Marion Elligsen, BScPhm, MSc, RPh, ACPR; Keith S Kaye, MD, MPH; and Andrew Shorr, MD, MPH, MBA, discuss key considerations for selecting empiric antibiotic regimens in patients with HABP/VABP in the intensive care unit, including: 

• The role of novel β-lactam/β-lactamase inhibitor combinations
• Use of clinical predictions scores (eg, Drug Resistance in Pneumonia [DRIP] score) to predict risk for pneumonia caused by multidrug-resistant pathogens
• Application of rapid diagnostic testing in critically ill patients with pneumonia, including current limitations
• Implementation of advanced antibiograms and clinical prediction scores
• Clinical utility of biomarkers for pneumonia (eg, procalcitonin)
• Application of updated nosocomial pneumonia classifications in clinical practice

Faculty:
Marion Elligsen, BScPhm, ​ MSc, RPh, ACPR​
Practice-Based Researcher​
Sunnybrook Research Institute​
Antimicrobial Stewardship Pharmacy Lead​
Department of Pharmacy​
Sunnybrook Health Sciences Centre​
Toronto, Ontario, Canada​

Keith S. Kaye, MD, MPH
Chief  
Division of Allergy, Immunology and Infectious Diseases
Professor of Medicine
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey

Andrew Shorr, MD, MPH, MBA​
Director​
Pulmonary and Critical Care Medicine​
Medstar Washington Hospital Center​
Washington, DC​

Content based on a CME program supported by an educational grant from Merck Sharp & Dohme Corp. 

Link to full program:
https://bit.ly/3HaZpYw

Link to downloadable slideset:
https://bit.ly/3UxHoqr

Today we are doing double duty: podcasting and parenting.  Fortunately our babies were well-behaved.  We talk about three trials for semaglutide and weight loss and a new 4 level pre-test probability rule for diagnosing PE.  We also talk about a retrospective study of cefazolin vs nafcillin for epidural abscess, a ferritin/procalcitonin ratio for differentiating bacterial from COVID pneumonia, and a new randomized controlled trial of intermediate thromboprophylaxis for ICU patients with COVID19.  Check it out!


Semaglutide for Weight Loss (STEP 1)
Semaglutide for Weight Loss in Diabetics (STEP 2)
Semaglutide + Intensive Calorie Restriction for Weight Loss (STEP 3)

4PEPS for Pulmonary Embolism
Nafcillin vs Cefazolin for Epidural Abscess
Ferritin/Procalcitonin Ratio for COVID-19 vs Bacterial Pneumonia
Intermediate Thromboprophylaxis for COVID-19 (INSPIRATION)








Music from https://filmmusic.io
"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)
License: CC BY (http://creativecommons.org/licenses/by/4.0/)

Hall of the Mountain King Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0 License
http://creativecommons.org/licenses/by/3.0/

In this episode, Eric and Joe do a deep dive on sepsis with Dr. Rob Stenstrom, Sepsis and Infections Lead for the EM Network. They discuss the most practical definition of sepsis in the ED and which diagnostic score to use. They find the bottom line on serum lactate, fluid treatment, and blood cultures and antibiotic timing. Rob answers questions on which pressor to use, central access timing, and the status of novel therapies. Plus, is there a genetic predisposition to developing sepsis?

Sepsis Stats

• 1 in 18 deaths in Canada involve Sepsis
• 30% of Canadians hospitalized with sepsis die within 1 month.

Related links

• Sepsis and Septic Shock – Diagnosis
• Sepsis with Hypotension and Septic Shock – Treatment
• Sepsis without Hypotension – Treatment
• Pediatric Septic Shock Management
• EM Network Sepsis and Soft Tissue Infections Research Program

End of Shift Hosts

Eric Angus
Eric Angus is an emergency physician and trauma team leader at Lions Gate Hospital. He is married with 15-year-old twins. His nonmedical interests include origami, meditation, mountain biking, skiing, rock climbing, just generally being outside, and drinking wine. He has a diploma in mountain medicine and volunteers for ski patrol and the North Shore Rescue team. He is an ATLS instructor. He dabbles in stoicism and Buddhist philosophies.

Joe Haegert
Joe Haegert practices emergency and trauma medicine at the Royal Columbian Hospital in New Westminster, British Columbia. He is a talented teacher, engaging speaker, and devoted clinician. He lives in South Surrey with his wife Sandy and managed to raise three children without much incident. Known for his unflagging enthusiasm, Joe enjoys all aspects of the outdoors and recently has taken to turning wooden burls into all manner of bowls and tables.

Disclaimer
The discussion within the End of Shift podcast may be graphic, and some listeners may find the language and content disturbing. The views and opinions expressed in this podcast are those of the participants and do not necessarily reflect the official policy or position of the BC Emergency Medicine Network.

Discussion of glucose control in type 2 diabetes.

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