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Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness,fast heart rate,fast breathing,sweating,anxiety,and increased thirst. This may be followed by confusion,unconsciousness,or cardiac arrest,as complications worsen.
Sepsis is a potentially life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs.
Septic shock is a potentially fatal medical condition that occurs when sepsis,which is organ injury or damage in response to infection,leads to dangerously low blood pressure and abnormalities in cellular metabolism. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defines septic shock as a subset of sepsis in which particularly profound circulatory,cellular,and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. Patients with septic shock can be clinically identified by requiring a vasopressor to maintain a mean arterial pressure of 65 mm Hg or greater and having serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%.
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. Symptoms include shortness of breath (dyspnea),rapid breathing (tachypnea),and bluish skin coloration (cyanosis). For those who survive,a decreased quality of life is common.
In immunology,systemic inflammatory response syndrome (SIRS) is an inflammatory state affecting the whole body. It is the body's response to an infectious or noninfectious insult. Although the definition of SIRS refers to it as an "inflammatory" response,it actually has pro- and anti-inflammatory components.
Eastern Virginia Medical School (EVMS) is a public medical school in Norfolk,Virginia. Founded by grassroots efforts in the Southeastern part of Virginia known as Hampton Roads,EVMS has historically not been affiliated with an undergraduate institution and therefore coordinates training through multiple medical centers in the Hampton Roads region. However,the school is the process of merging with nearby Old Dominion University to create a comprehensive university with EVMS being the medical school component of the larger university. This merger is to be completed by July 1,2024. EVMS campus includes the 555-bed Sentara Norfolk General Hospital,the region's only tertiary level 1 trauma medical care facility,and the 212-bed Children's Hospital of The King's Daughters,a regional pediatric referral care facility and only stand-alone children's hospital in the state. EVMS is the first institution in the US to have produced a viable fetus through in vitro fertilization. EVMS is most known for its reproductive medicine and simulation/standardized-patient education as well as research in pediatrics,geriatrics,diabetes,and cancer. In addition,EVMS is well known for its leadership in community service and medical missions as evidenced by faculty and alumni responsible for the founding of Operation Smile,Physicians for Peace,Global Brigades,and CONRAD.
A banana bag is a bag of IV fluids containing vitamins and minerals. The bags typically contain thiamine,folic acid,and magnesium sulfate,and are usually used to correct nutritional deficiencies or chemical imbalances in the human body. The solution has a yellow color,hence the term "banana bag".
The Surviving Sepsis Campaign (SSC) is a global initiative to bring together professional organizations in reducing mortality from sepsis. The purpose of the SSC is to create an international collaborative effort to improve the treatment of sepsis and reduce the high mortality rate associated with the condition. The Surviving Sepsis Campaign and the Institute for Healthcare Improvement have teamed up to achieve a 25 percent reduction in sepsis mortality by 2009. The guidelines were updated in 2016 and again in 2021.
Critical illness–related corticosteroid insufficiency is a form of adrenal insufficiency in critically ill patients who have blood corticosteroid levels which are inadequate for the severe stress response they experience. Combined with decreased glucocorticoid receptor sensitivity and tissue response to corticosteroids,this adrenal insufficiency constitutes a negative prognostic factor for intensive care patients.
The following outline is provided as an overview of and topical guide to emergency medicine:
Emanuel Rivers is a physician born and raised in River Rouge,Michigan which is a suburb of Detroit,MI. He is board certified in emergency medicine,internal medicine and critical care medicine. Rivers has published extensively in the field of shock,sepsis and resuscitation.
Vasodilatory shock,vasogenic shock,or vasoplegic shock is a medical emergency belonging to shock along with cardiogenic shock,septic shock,allergen-induced shock and hypovolemic shock. When the blood vessels suddenly relax,it results in vasodilation. In vasodilatory shock,the blood vessels are too relaxed leading to extreme vasodilation and blood pressure drops and blood flow becomes very low. Without enough blood pressure,blood and oxygen will not be pushed to reach the body's organs. If vasodilatory shock lasts more than a few minutes,the lack of oxygen starts to damage the body's organs. Vasodilatory shock like other types of shock should be treated quickly,otherwise it can cause permanent organ damage or death as a result of multiple organ dysfunction.
Intravenous Ascorbic Acid,is a process that delivers soluble ascorbic acid directly into the bloodstream. It is not approved for use to treat any medical condition.
Drug repositioning is the repurposing of an approved drug for the treatment of a different disease or medical condition than that for which it was originally developed. This is one line of scientific research which is being pursued to develop safe and effective COVID-19 treatments. Other research directions include the development of a COVID-19 vaccine and convalescent plasma transfusion.
Proning or prone positioning is the placement of patients into a prone position so that they are lying on their front. This is used in the treatment of patients in intensive care with acute respiratory distress syndrome (ARDS). It has been especially tried and studied for patients on ventilators but,during the COVID-19 pandemic,it is being used for patients with oxygen masks and CPAP as an alternative to ventilation.
Pierre Kory is an American critical care physician who gained attention during the COVID-19 pandemic for advocating widespread off-label use of certain drugs as treatments for COVID-19,as president and co-founder of the Front Line COVID-19 Critical Care Alliance (FLCCC). Kory testified twice to the U.S. Senate regarding COVID-19. During his testimony in December 2020,Kory erroneously claimed that the antiparasitic medication ivermectin was a "wonder drug" with "miraculous effectiveness" against COVID-19.
The Front Line COVID-19 Critical Care Alliance (FLCCC) is a group of physicians and former journalists formed in April 2020 that has advocated for various unapproved,dubious,and ineffective treatments for COVID-19. The group is led by Paul E. Marik and Pierre Kory. Both would later join conservative or right-wing groups promoting COVID-19 vaccine hesitancy and misinformation.
Ivermectin is an antiparasitic drug that is well established for use in animals and people. The World Health Organization (WHO),the European Medicines Agency (EMA),the United States Food and Drug Administration (FDA),and the Infectious Diseases Society of America (IDSA) all advise against using ivermectin in an attempt to treat or prevent COVID-19.
Maurizio Cecconi is a British-Italian anesthesiologist,intensivist,and academic. Cecconi's research focuses on improving the outcomes of high risk surgical patients,especially with better risk identification and perioperative haemodynamic optimisation,and improving the outcome of critically ill patients,especially suffering from cardiovascular shock,acute respiratory failure and sepsis. He has been Clinical Director of Adult Critical Care at St George's and the Clinical Lead for critical care at Epsom and St Helier's hospital from 2015 to 2016. He was President of the European Society of Intensive Care Medicine (ESICM) from 2020 to 2022 throughout the COVID-19 Pandemic. Cecconi has been the Head of the Department and Full Professor of Anaesthesia and Intensive Care at Humanitas Research Hospital and Humanitas University since 2018.
Anthony Gordon is a British clinician scientist and the Chair of Anaesthesia &Critical Care at Imperial College London and works as an intensive care consultant at Imperial College Healthcare NHS Trust.
References
- ↑ "Paul Ellis Marik – Curriculum Vitae" (PDF). Eastern Virginia Medical School. Retrieved July 21, 2021.
- 1 2 "Paul Marik, MD, Named Director, Division of Pulmonary and Critical Care" (PDF). JeffNews. Thomas Jefferson University. April 1, 2005. p. 2.
- ↑ "Los cinco de la ivermectina, el antiparasitario contra el Covid por el que hasta se censura". ELMUNDO (in Spanish). June 24, 2021.
- 1 2 Gorski D (August 7, 2023). "The American Board of Internal Medicine finally acts against two misinformation-spreading doctors". Science-Based Medicine.
- 1 2 3 4 Fiore, Kristina (January 6, 2021). "What's Behind the Ivermectin-for-COVID Buzz?". medpagetoday.com. Retrieved September 24, 2021.
- 1 2 Hilary Brueck (September 17, 2021). "2 fringe doctors created the myth that ivermectin is a 'miracle cure' for COVID-19 — whipping up false hope that could have deadly consequences". Business Insider.
- 1 2 Larche, Jessica (September 27, 2021). "Norfolk doctor leading charge for controversial COVID-19 treatment". WTKR. Retrieved October 9, 2021.
- 1 2 3 4 Rubin R (July 2019). "Wide Interest in a Vitamin C Drug Cocktail for Sepsis Despite Lagging Evidence". JAMA. 322 (4): 291–293. doi:10.1001/jama.2019.7936. PMID 31268477. S2CID 195788169.
- ↑ Turner, Kelly Jane (January 28, 2021). "Doctor who discovered Ivermectin use for Covid-19 was born in SA, studied at Wits". Independent Online .
- ↑ "Biography – Dr. Paul E.Marik". benthamscience.com.
- ↑ Keene, Rochelle (2013). "Our Graduates, 1924–2012" (PDF). Faculty of Health Sciences, University of the Witwatersrand. Retrieved March 27, 2022.
- 1 2 "Profiles – Eastern Virginia Medical School (EVMS), Norfolk, Hampton Roads". evms.edu. Retrieved September 24, 2021.
- ↑ "Handbook of Evidence-Based Critical Care" (PDF). Respiratory Care. 48 (6). June 2003.
- ↑ Ho, K. M. (March 2011). "Book Review: Handbook of Evidence-Based Critical Care. Second edition". Anaesthesia and Intensive Care. 39 (2): 320. doi: 10.1177/0310057X1103900230 . S2CID 86622425.
- ↑ Papadakos, Peter J. (June 1, 2003). "Book Review: Handbook of Evidence-Based Critical Care. Paul Ellis Marik MD MBBCh. New York: Springer-Verlag. 2001. Soft cover, illustrated, 535 pages". Respiratory Care. 48 (6): 625–626. Retrieved October 6, 2021.
- ↑ "New CHEST Editorial Board Members" (pdf). Chest. 122 (1): 13. July 2002. doi: 10.1378/chest.122.1.13 .
- ↑ "Skilled teacher wins national recognition". EVMS Magazine. Vol. 9, no. 3. Eastern Virginia Medical School. 2016–2017. Retrieved June 9, 2022.
- ↑ Raghu, Ganesh; Collard, Harold R.; Egan, Jim J.; Martinez, Fernando J.; Behr, Juergen; Brown, Kevin K.; Colby, Thomas V.; Cordier, Jean-François; Flaherty, Kevin R.; Lasky, Joseph A.; Lynch, David A.; Ryu, Jay H.; Swigris, Jeffrey J.; Wells, Athol U.; Ancochea, Julio; Bouros, Demosthenes; Carvalho, Carlos; Costabel, Ulrich; Ebina, Masahito; Hansell, David M.; Johkoh, Takeshi; Kim, Dong Soon; King, Talmadge E.; Kondoh, Yasuhiro; Myers, Jeffrey; Müller, Nestor L.; Nicholson, Andrew G.; Richeldi, Luca; Selman, Moisés; Dudden, Rosalind F.; Griss, Barbara S.; Protzko, Shandra L.; Schünemann, Holger J. (March 15, 2011). "An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management". American Journal of Respiratory and Critical Care Medicine. 183 (6): 788–824. doi:10.1164/rccm.2009-040GL. PMC 5450933 . PMID 21471066.
- ↑ Dellinger, R. P.; Levy, Mitchell M.; Rhodes, Andrew; Annane, Djillali; Gerlach, Herwig; Opal, Steven M.; Sevransky, Jonathan E.; Sprung, Charles L.; Douglas, Ivor S.; Jaeschke, Roman; Osborn, Tiffany M.; Nunnally, Mark E.; Townsend, Sean R.; Reinhart, Konrad; Kleinpell, Ruth M.; Angus, Derek C.; Deutschman, Clifford S.; Machado, Flavia R.; Rubenfeld, Gordon D.; Webb, Steven; Beale, Richard J.; Vincent, Jean-Louis; Moreno, Rui (February 2013). "Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock, 2012". Intensive Care Medicine. 39 (2): 165–228. doi:10.1007/s00134-012-2769-8. PMC 7095153 . PMID 23361625.
- ↑ "Awards" (PDF). ACP. Archived from the original (PDF) on January 30, 2019. Retrieved March 27, 2022.
- ↑ "Paul Ellis Marik – Editorial Board – Pharmacology & Therapeutics – Journal – Elsevier". journals.elsevier.com. Elsevier. Retrieved August 13, 2021.
- ↑ Adrienne Mayfield (May 19, 2021). "EVMS professor reprimanded by Virginia Board of Medicine". WAVY-TV.
- ↑ "Case Number 203034" (PDF). Virginia Board of Medicine. March 16, 2021.
- ↑ "Doctor gets letter of suspension just after suing Sentara Healthcare for chance to use ivermectin on COVID-19 patients". 13newsnow.com. November 23, 2021. Retrieved January 9, 2022.
- ↑ Ponton, Brendan (November 23, 2021). "Attorney, Sentara quiet over Dr. Marik's hospital suspension". WTKR. Retrieved March 27, 2022.
- ↑ "Dr. Marik resigns from position at EVMS in midst of legal battle with Sentara over use of ivermectin". WTKR. January 5, 2022. Retrieved March 27, 2022.
- ↑ Fiore, Kristina (January 5, 2022). "Controversial Doc Resigns From Medical School". medpagetoday.com. Retrieved January 9, 2022.
- ↑ "Norfolk doctor seeking to use ivermectin to treat COVID-19 resigns from EVMS". WVEC. January 6, 2022. Retrieved January 9, 2022.
- ↑ Jackson, Jon (January 6, 2022). "Doctor in Middle of Battle to Prescribe Ivermectin for COVID Patients Resigns as Professor". Newsweek.
- ↑ Marik, Paul E.; Khangoora, Vikramjit; Rivera, Racquel; Hooper, Michael H.; Catravas, John (2017). "Hydrocortisone, Vitamin C, and Thiamine for the Treatment of Severe Sepsis and Septic Shock". Chest. Elsevier BV. 151 (6): 1229–1238. doi:10.1016/j.Chest.2016.11.036. ISSN 0012-3692. PMID 27940189. S2CID 3509326.
- ↑ "The Marik Protocol: Have We Found a "Cure" for Severe Sepsis and Septic Shock? – Emergency Medicine Blog". REBEL EM – Emergency Medicine Blog. April 7, 2017. Retrieved July 22, 2021.
- ↑ "Vitamin C Drug Cocktail for Sepsis". HealthManagement. July 9, 2019. Retrieved September 24, 2021.
- ↑ Lee YR, Vo K, Varughese JT (May 2021). "Benefits of combination therapy of hydrocortisone, ascorbic acid and thiamine in sepsis and septic shock: A systematic review". Nutr Health. 28 (1): 77–93. doi:10.1177/02601060211018371. PMID 34039089. S2CID 235215735.
- ↑ "FLCCC Doctors Plan to Fight Board Decision". FLCCC Alliance. August 8, 2023.
- ↑ Rawat, D; Roy, A; Maitra, S; Gulati, A; Khanna, P; Baidya, DK (November 2021). "Vitamin C and COVID-19 treatment: A systematic review and meta-analysis of randomized controlled trials". Diabetes & Metabolic Syndrome. 15 (6): 102324. doi:10.1016/j.dsx.2021.102324. PMC 8552785 . PMID 34739908.
- ↑ Hesman Saey, Tina (August 2, 2020). "Hydroxychloroquine can't stop COVID-19. It's time to move on, scientists say". Science News. ScienceNews. Retrieved March 27, 2022.
- ↑ Offord C (March 2, 2021). "Frontiers Removes Controversial Ivermectin Paper Pre-Publication". The Scientist.
- ↑ Marcus A (November 10, 2021). "Bad MATH+? Covid treatment paper by Pierre Kory retracted for flawed results". Retraction Watch.
- ↑ "Retraction Notice". Journal of Intensive Care Medicine. November 9, 2021. doi: 10.1177/08850666211049062 . PMID 34749558. S2CID 243863375.
- ↑ "The FLCCC Physicians". FLCCC. Archived from the original on November 1, 2020. Retrieved November 12, 2021.
- ↑ Fiore K (May 19, 2022). "Misinformation Docs See Their Political Stars Rise". MedPage Today.
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