Current Topics in Shock and Sepsis Management: Traumatic Hemorrhagic Shock and Septic Shock

This course combines audio and digital components to review critical care management of traumatic hemorrhagic shock management as well as sepsis and septic shock. Includes 9.5 AMA PRA Category 1 Credits™.

Modules

• Module 1: An Evidence-Based Approach to Nonoperative Management of Traumatic Hemorrhagic Shock in the Emergency Department + EMplify podcast audio discussion
• Module 2: Updates and Controversies in the Early Management of Sepsis and Septic Shock + EMplify podcast audio discussion
• Module 3: Good SIRS let’s sit on the (q)SOFA and discuss the aMEWSing NEWS (audio lecture)
• Module 4: How much fluid would Goldilocks give a septic shock patient? (audio lecture)
• Module 5: Traumatic Hemorrhagic Shock, Massive Transfusion, and Intubation (audio webinar)

We hope you enjoy this course! If you have any questions, our Customer Service Team is here to help Monday - Friday, 9:00am-5:30pm EST, and can be reached at 678-366-7933 or ebm@ebmedicine.net

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Product Details

Publication Date: April 15, 2021

CME Expiration Date: October 31, 2023

CME Accreditation: EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This activity has been planned and implemented in accordance with the accreditation requirements and policies of the ACCME. Credit Designation: EB Medicine designates this enduring material for a maximum of 9.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Current Topics in Shock and Sepsis Management: Traumatic Hemorrhagic Shock and Septic Shock is eligible for 9.5 Category 2-A or 2-B credit hours by the American Osteopathic Association. The “An Evidence-Based Approach to Nonoperative Management of Traumatic Hemorrhagic Shock in the Emergency Department” journal issue is approved by the American College of Emergency Physicians for 4 hours of Category I credit. The “Updates and Controversies in the Early Management of Sepsis and Septic Shock” journal issue is approved by the American College of Emergency Physicians for 4 hours of Category I credit.

Table of Contents

Module 1: An Evidence-Based Approach to Nonoperative Management of Traumatic Hemorrhagic Shock in the Emergency Department + EMplify podcast audio discussion

1. Abstract
2. Case Presentations
3. Introduction
4. Critical Appraisal of the Literature
5. Etiology and Pathophysiology
   1. The Lethal Triad
6. Differential Diagnosis
7. Prehospital Care
   1. Stabilization
      1. Tourniquet Use
      2. Hemostatic Dressings
      3. Airway and Breathing
      4. Circulation
      5. Tranexamic Acid
      6. Temperature Management
   2. Transport
8. Emergency Department Preparation
9. Emergency Department Evaluation
   1. Assessment and Recognition of the Hemorrhagic Shock State
10. Diagnostic Studies
    1. Ultrasound and Other Imaging
    2. Laboratory Testing
    3. Viscoelastic Clot Testing
11. Treatment
    1. Hemorrhage Control With In-Hospital Hemostatic Devices
    2. Resuscitative Endovascular Balloon Occlusion of the Aorta
    3. Cardiac Arrest
    4. Resuscitative Thoracotomy
    5. Airway
    6. Breathing
    7. Circulation
       1. Fluid Resuscitation
       2. Massive Transfusion
       3. Crystalloid Therapy
       4. Whole Blood and Red Blood Cells
       5. Plasma
       6. Platelets
       7. Blood Product Ratios
       8. Permissive Hypotension
    8. Hemostatic Products
       1. Tranexamic Acid
       2. Prothrombin Complex Concentrate
       3. Direct Oral Anticoagulant Reversal Agents
       4. Fibrinogen
12. Special Circumstances and Populations
    1. Central Nervous System Injury
    2. Pediatric Patients
13. Controversies and Cutting Edge
14. Disposition
15. Key Points
16. Summary
17. Time- and Cost-Effective Strategies
18. Risk Management Pitfalls for Traumatic Hemorrhagic Shock
19. Case Conclusions
20. Clinical Pathway for Management of Traumatic Hemorrhagic Shock in the Emergency Department
21. Tables and Figures
    1. Table 1. Traumatic Hemorrhagic Shock Differential
    2. Table 2. Signs and Symptoms of Hemorrhage, by Class (ATLS®)
    3. Table 3. Clinical Prediction Calculators for Shock
    4. Figure 1. Bystander Awareness Campaign Information
    5. Figure 2. Fluid in Morison Pouch on eFAST
    6. Figure 3. TEG Waveforms in Various Coagulopathic States Showing Clot Firmness Versus Time
    7. Figure 4. ER-REBOA™ PLUS Catheter
    8. Figure 5. Zones of Aortic Occlusion in Resuscitative Endovascular Balloon Occlusion of the Aorta
22. References

Module 2: Updates and Controversies in the Early Management of Sepsis and Septic Shock + EMplify podcast audio discussion

1. Abstract
2. Case Presentations
3. Introduction
4. Definitions and Terminology
5. Critical Appraisal of the Literature
6. Epidemiology
7. Etiology and Pathophysiology
8. Differential Diagnosis
9. Prehospital Care
10. Emergency Department Evaluation
    1. History
    2. Physical Examination
11. Diagnostic Studies
    1. Laboratory Testing
    2. Lactate Versus Central Venous Oxygen Saturation
    3. Procalcitonin
    4. Imaging
    5. Scoring Systems
12. Treatment
    1. Initial Management
    2. COVID-19 Effect on Sepsis Screening and Management
    3. Intravenous Fluids
       1. Fluid Volume and Timing
       2. Fluid Type
       3. Fluid Status Assessment
    4. Antibiotics
       1. Antibiotic Timing
       2. Antibiotic Coverage
    5. Vasopressors and Inotropes
       1. Norepinephrine Versus Dopamine
       2. Vasopressin
       3. Epinephrine
       4. Phenylephrine
       5. Vasopressor Timing
          • Angiotensin II
    6. Corticosteroids
    7. Blood Transfusion
13. Special Populations
    1. Pregnant Patients
    2. Patients With End-Stage Renal Disease
14. Controversies and Cutting Edge
    1. Controversies
       1. Hour-1 Bundle
       2. Fluid Volume
       3. Etomidate
       4. Vitamin C
    2. Cutting Edge
15. Disposition
    1. End-of-Life Care
16. Summary
17. Risk Management Pitfalls for Sepsis Management in the Emergency Department
18. Time- and Cost-Effective Strategies
19. Case Conclusions
20. Clinical Pathways
    1. Clinical Pathway for Sepsis Screening in the Emergency Department
    2. Clinical Pathway for Initial Management of Patients With Sepsis
21. Tables
    1. Table 1. Sequential Organ Failure Assessment Score
    2. Table 2. Definitions of Sepsis, Severe Sepsis, and Septic Shock
    3. Table 3. Noninfectious Conditions That May Mimic Sepsis
    4. Table 4. Potential Sources of Infection Associated With Sepsis, by Organ System
    5. Table 5. Historical and Physical Examination Findings Concerning for Sepsis
    6. Table 6. Antibiotic Recommendations by Source of Infection
22. References