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!

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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

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

Fluid Administration in End-Stage Renal Disease for Severe Sepsis and Septic Shock by Shyam Murali, MD

Background: In end-stage renal disease (ESRD) patients on hemodialysis (HD), infection is the second most common cause of mortality after cardiovas...
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

Steroids in Septic Shock via George Willis, MD

“You’re in the emergency department, you have a patient who EMS has brought in from a nursing home…who’s excited? Right, nobody is. And they are br...
Tactical Medicine News

SEPSIS-ACT: Selepressin in Septic Shock

Background: Septic shock is the most severe form of sepsis. It is characterized by vasodilation and increased capillary permeability leading to hyp...
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

ANDROMEDA-SHOCK: Peripheral Perfusion vs Serum Lactate in Septic Shock

Background: Based on the Surviving Sepsis Campaign, hemodynamic resuscitation of sepsis patients is done by repeating serum lactic acid levels ever...
Tactical Medicine News

The CENSER Trial: Early Norepinephrine in Septic Shock

Background: Standard management of septic shock has included, IV fluids until optimal intravascular volume is achieved, appropriate early antibioti...
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

Should we Pump up the Juice (Steroids) in Septic Shock?

Background: A Cochrane review was published in 2015 evaluating 33 trials with 4,268 participants to evaluate the effects of corticosteroids on deat...
Tactical Medicine News

Episode 93 – PALS Guidelines

I remember when I started practicing emergency medicine a decade and a half ago it seemed that any kid who came to our ED in cardiac arrest died. I...
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

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...
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