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  1. Jan 02, 2022 · Anthony Contents 1 Anthony Cumia (April 26, 1961- ) 1.1 The Early Years 1.2 Before the Laughter 1.3 Fun Facts 1.4 Firing 1.5 Anthony's List of Impressions 2 See Also Anthony Cumia (April 26, 1961- ) Anthony Cumia was one half of the radio duo Opie and Anthony . He now hosts his own show called The Anthony Cumia Show .

  2. Jan 09, 2022 · Background. Color Black White Red Green Blue Yellow Magenta Cyan Transparency Opaque Semi-Transparent Transparent. Window. Color Black White Red Green Blue Yellow Magenta Cyan Transparency Transparent Semi-Transparent Opaque. Font Size. 50% 75% 100% 125% 150% 175% 200% 300% 400%. Text Edge Style.

  3. Jan 04, 2022 · Jan 04, 2022 · • Rhode Island’s average gas price remained level at $3.37 per gallon, according to AAA Northeast. That's 3 cents lower than it was a month ago, $1.15 higher than January 3, 2021, and 9 cents higher than the current national average.

  4. › category › episode-notesEpisode Notes – Pratchat

    Dec 25, 2021 · The lockdown-related Discworld questions in #Pratchat30 begin around 1 hour, 5 minutes and 41 seconds in. The first lockdown in Melbourne – and the rest of Australia – began on March 29, 2020. Melbourne had subsequent lockdowns from July 9 to October 26 2020, February 12 to 17 2021, and from May 27 until – at the time of last update ...

    • Abstract
    • Case Presentations
    • Introduction
    • Definitions and Terminology
    • Critical Appraisal of The Literature
    • Risk Management Pitfalls For Sepsis Management in The Emergency Department
    • References

    Sepsis is a common and life-threatening condition that requires early recognition and swift initial management. Diagnosis and treatment of sepsis and septic shock are fundamental for emergency clinicians, and include knowledge of clinical and laboratory indicators of subtle and overt organ dysfunction, infection source control, and protocols for prompt identification of the early signs of septic shock. This issue is a structured review of the literature on the management of sepsis, focusing on the current evidence, guidelines, and protocols.

    A 65-year-old man with COPD and diabetes presents from home with a productive cough (green sputum) for 1 week, dyspnea on exertion, and fever. Albuterol at home provided no relief. His vital signs are: heart rate, 102 beats/min; respiratory rate, 22 breaths/min; blood pressure, 130/89 mm Hg, and SpO2, 94% on room air. He is speaking in full sentences and does not appear to be in respiratory distress. He has rales at the right lung base, mild wheezes, and tachycardia. Chest radiograph confirms right lower lobe pneumonia. The patient has no recent hospitalizations. You believe that he looks clinically well and may be able to be discharged home with antibiotics, but you are also concerned for sepsis and wonder if this would be a wise decision... A 45-year-old man with hypertension and prostate cancer in remission presents complaining of 3 days of burning with urination, fevers, and chills. His vital signs are: heart rate, 110 beats/min; respiratory rate, 20 breaths/min; blood pressure,...

    Sepsis is triggered by a systemic infection and is a life-threatening, dysregulated response to infection.1 Immune abnormalities induced by invading pathogens or tissue damage produce both the inflammatory and immunosuppressive features of the disease, which causes organ dysfunction and can lead to death. Sepsis may lead to cellular abnormalities and perfusion deficits, causing septic shock. Optimal management strategies for sepsis have been an issue of intense research since a landmark study by Rivers and colleagues published in 2001 identified a 16% mortality reduction with randomization to an early aggressive care bundle termed early goal-directed therapy (EGDT). EGDT involves the administration of fluids, inotropes, and blood, and the achievement of hemodynamic goals to improve tissue oxygenation, as indicated by a central venous oxygen saturation (ScvO2) > 70%.2 After 3 recent multicenter trials failed to validate the results of that study, however, EGDT is no longer recommende...

    The diagnosis of sepsis has undergone a metamorphosis since the inception of standardized definitions in 1991.10 Shifting away from the systemic inflammatory response syndrome (SIRS) criteria previously utilized,11 in 2014 the Society of Critical Care Medicine and the European Society of Intensive Care Medicine convened a task force and, by an expert consensus process, agreed in 2016 on updated definitions and criteria to be tested clinically. The Third International Consensus Definitions for Sepsis and Septic Shock (“Sepsis-3”) redefined sepsis as “life-threatening organ dysfunction caused by a dysregulated host response to infection.”1 Sepsis-3 also redefined septic shock as “hypotension not responsive to fluid resuscitation,” with the added requirement for vasopressors to maintain a mean arterial pressure (MAP) ≥ 65 mm Hg and a lactate > 2 mmol/L. These new definitions were adopted by the 2016 Surviving Sepsis Campaign: International Guidelines for the Management of Sepsis and Se...

    To evaluate clinically relevant articles regarding the diagnosis and early management of sepsis, severe sepsis, and septic shock, a search of the National Library of Medicine PubMed database was performed using the following search terms: sepsis management, septic shock management, andclinical sepsis treatment guidelines, with a date range of 2000 to 2018. Acknowledging the breadth of the sepsis literature, additional specific searches were performed including intravenous fluids, antibiotics, vasopressors, corticosteroids, lactate, lactate clearance, andsepsis.References relevant to prehospital and emergency department (ED) care of septic patients were included. Only adult, human studies were considered, and publications in English (with the exception of 3 Chinese studies on lactate clearance). Current consensus guidelines were also reviewed. Guidelines have recently been augmented with high-powered randomized clinical trials of sepsis and septic shock that evaluated management stra...

    1. “I didn’t reassess the patient’s lactate.” Lactate clearance can aid in assessing a patient’s response to treatment. Persistently elevated lactate may indicate inadequate resuscitation or alternative diagnoses. Particular attention should be given to patients with limited lactate clearance, as persistent elevation is associated with poor outcomes. 5. “I wasn’t sure of the patient’s source of infection, so I waited to give antibiotics.” Patients with presumed sepsis and hypotension have an increased mortality when antibiotics are delayed. In such cases, administering broad-spectrum antibiotics prior to source confirmation is recommended. For stable patients in whom sepsis is being considered, source-directed antibiotics should be administered as soon as practical and, ideally, within 1 hour of sepsis recognition. 9. “I used dopamine as the first-line vasopressor for septic shock.” Recent literature and guidelines support norepinephrine as the first-line vasopressor for septic shoc...

    Evidence-based medicine requires a critical appraisal of the literature based upon study methodology and number of subjects. Not all references are equally robust. The findings of a large, prospective, randomized, and blinded trial should carry more weight than a case report. To help the reader judge the strength of each reference, pertinent information about the study, such as the type of study and the number of patients in the study is included in bold type following the references, where available. In addition, the most informative references cited in this paper, as determined by the author, are highlighted. 1. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801-810. (Policy) 2. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345(19):1368-1377. (Randomized clinical trial; 263 patients) 3. Mounc...

  5. › en › ACold War - Wikipedia

    Dec 22, 2021 · Cold War. 12 March 1947 – 26 December 1991. (44 years and 9 months) Part of the Post-WWII era. NATO and Warsaw Pact states during the Cold War-era. The " Three Worlds " of the Cold War era, April – August 1975. First World: Western Bloc led by the United States and its allies.

  6. Jan 09, 2022 · 1296 Earl Floris V signs accord with French King. 1317 Phillips V, the Tall, crowned King of France. 1349 700 Jews of Basel Switzerland, burned alive in their houses. 1431 Judges' investigations for the trial of Joan of Arc begin in Rouen, France, the seat of the English occupation government. 1464 1st meeting of States-General of Netherlands.

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