The Blog

Thanks for dropping by! We have curated an incredible collection of the best articles from the leading Emergency Medicine, Tactical Medicine, Prehospitial Medicine, Austere & Remote Medicine authors, as well as Survival Medicine gurus and many others!

We hope you find something of interested to you, please use the search bar on top to narrow down what you are looking for.

As always, all credit is given to the original author and origin publication.

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Tactical Medicine News

The CLASSIC Trial: IV Fluid Restriction in Septic Shock

by Marco Torres
Jun 23, 2022
Background: The Surviving Sepsis Campaign guidelines recommend an initial fixed volume of 30mL/kg of IDEAL body weight within the first 3 hours of ...
Tactical Medicine News

EM Quick Hits 36 – Surviving Sepsis, Angle Closure Glaucoma, Bougies, Frostbite, Hot/Altered Patient, Central Cord Syndrome

In this month's EM Quick Hits podcast: Brit Long on Surving Sepsis Campaign -2021 Updates, Nour Khatib on rural medicine case - angle closure glauc...
Tactical Medicine News

The VICTAS Trial: How Many More RCTs do we Need on the Metabolic Cocktail in Sepsis?

Background: Since the publication of the before and after Marik trial [1] published in 2016, there have been six randomized clinical trials trying ...
Tactical Medicine News

The ATESS Trial: Time to Let Go of the Metabolic Cocktail

Background: The only well-established treatments for sepsis and septic shock are antibiotic therapy and source control.  Septic shock, the most sev...
Tactical Medicine News

Let’s Get Our ACTS Together: The Metabolic Cocktail and Septic Shock Again

Background: Though it’s been stated numerous times on this blog, it bears repeating: the pillars of sepsis care remain early identification of seps...
Tactical Medicine News

The ORANGES Trial: Why You Can’t Just Read the Abstract

Background: The cornerstones of sepsis management continues to include early identification, early appropriate empiric antibiotics, definitive sour...
Tactical Medicine News

The HYVCTTSSS Trial: The “Metabolic Cocktail” in Another RCT

Background: Getting the basics right in all illness is vital. In sepsis, this means appropriate use of antibiotics, judicious fluid resuscitation, ...
Tactical Medicine News

REBEL Cast Ep 76: The 65 Trial – Shooting for a Lower MAP in Older Patients with Sepsis?

Background: Vasopressors are often used to improve hypotension and perfusion in an effort to decrease mortality of patients with septic shock. Mean...
Tactical Medicine News

The FABLED Trial: Blood Cultures 1st, Then Antibiotics in Sepsis

Background: The cornerstones of sepsis management include early identification, early antimicrobial administration, and source control.  The Surviv...
Tactical Medicine News

REBEL Cast Ep74 – Is it all About the VITAMINS in Sepsis?

Background: The combination of vitamin C, hydrocortisone and thiamine in sepsis has been a topic of hot debate in the past couple years.  There is ...
Tactical Medicine News

CITRIS-ALI: Vitamin C in Patients with Sepsis and Severe Acute Respiratory Failure

Background: In 2016, Paul Marik published a study in Chest [2] demonstrating a decrease in hospital mortality of 32% for sepsis patients treated wi...
Tactical Medicine News

Are Antibiotics for Sepsis in One Hour Feasible in the ED?

Background: Despite minimal high-quality supporting evidence (Seymour 2017, Liu 2017, Ferrer 2014, Sterling 2015), regulatory bodies have pushed fo...
Tactical Medicine News

REBEL Cast Ep70 – Time to Antibiotics in Sepsis

Background: Antibiotics are one of the cornerstones of therapy in the treatment of sepsis/septic shock, however according to the Surviving Sepsis C...
Tactical Medicine News

Ep 122 Sepsis and Septic Shock – What Matters from EM Cases Course

In this podcast Dr. Sara Gray, intensivist and emergency physician, co-author of The CAEP Sepsis Guidelines, answers questions such as: How does on...
Tactical Medicine News

Early Sepsis Screening in the Emergency Department

Background Information: Sepsis is a complex syndrome frequently encountered in the ED. This infection-triggered, multifaceted disorder of life-thre...
Tactical Medicine News

The SIRS & qSOFA Confusion in Sepsis

Background: It is well established that the rapid identification of patients with sepsis is needed in order to initiate timely care to improve morb...
Tactical Medicine News

APROCCHSS: More on Steroids in Septic Shock

Background: There have now been several trials published on the use of steroids in sepsis.  In 2002, we had the Annane Trial, with 299 patients sho...
Tactical Medicine News

Episode 37 – Definitions and Identification of Sepsis: Sepsis 2.0 vs Sepsis 3.0

Background: Just a few months ago the surviving sepsis campaign published their international guidelines for management of sepsis and septic shock ...
Tactical Medicine News

The Marik Protocol: Have We Found a “Cure” for Severe Sepsis and Septic Shock?

Background: The overall mortality in sepsis has decreased quite a bit in the last decade or so, however for a subset of patients, like those with ...
Tactical Medicine News

Is Fever the New Hotness in Sepsis?

Background: With the introduction of sepsis 3.0, came the quick sepsis related organ failure assessment (qSOFA) score. The purpose of this score is...
Tactical Medicine News

The HYPRESS Trial: Early Steroids to Prevent Septic Shock

Background: The most recent surviving sepsis campaign recommends the use of hydrocortisone in patients with refractory septic shock (i.e. vasopress...
Tactical Medicine News

Time to Antibiotics in Sepsis: A Metric Not Supported by “High Quality” Evidence

Background: Some of the major take home points from the sepsis trilogy of studies recently published (ProCESS, ARISE, and ProMISe) was that early i...
Tactical Medicine News

REBEL Cast Episode 9: Sepsis Care in 2015

So I was recently invited to the Texas College of Emergency Physicians meeting in Austin, TX (April 23rd – 26th, 2015) and was asked to give a lect...
Tactical Medicine News

The Protocolised Management in Sepsis (ProMISe) Trial

Since 2002, the surviving sepsis campaign (SSC) has stated that best practice in sepsis care includes: early recognition, source control, appropria...
Tactical Medicine News

The New Age of Sepsis Management

There are more than 750,000 cases of severe sepsis and septic shock in the US each year.  Most patients who present with sepsis receive their initi...
Tactical Medicine News

Any Benefit to Adjunct Prednisone Therapy in Community Acquired Pneumonia?

Background: Respiratory tract infections and pneumonia are the 3rd leading cause of death worldwide.  Although morbidity and mortality has improved...
Tactical Medicine News

REBEL Cast Episode 2: Isolated Vomiting in Pediatric Minor Head Trauma & Early Detection of SIRS in the ED

Welcome to REBEL Cast August 2014, where Matt, Swami, and I are going to tackle a couple more scenarios to help your clinical practice. Today, we a...
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