Archive for category: Clinical

The ENDAO Trial: Is Apneic Oxygenation a Futile Intervention in ED RSI?

21 Aug
August 21, 2017

Background: One of the most feared complications associated with rapid sequence intubation (RSI) is hypoxemia ultimately leading to cardiac arrest.  The FELLOW Trial, a recent randomized controlled trial demonstrated no difference in hypoxemia rates between patients that received apneic oxygenation and those that did not (i.e. “usual practice”) in the ICU.  What many forget about […]

The Utility of Amiodarone in Cardiac Arrest – Systematic Review and Meta-Analysis

14 Aug
August 14, 2017

Background: In 2016 the annual incidence of out-of-hospital cardiac arrest (OHCA) in the United States was roughly 360,000 and 209,000 for in-hospital cardiac arrest (IHCA) (Mozaffarian 2016). Though survival rates are relatively dismal, arrests in the setting of shock amenable rhythms – ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT) – have an overall better […]

Spinal Immobilization in Trauma Patients

07 Aug
August 7, 2017

Background: It has been common practice in trauma to place patients in cervical collars and on long backboards (LBBs) to achieve spinal immobilization. LBBs are used to help prevent spinal movement and facilitate extrication of patients. Cervical collars (C-Collars) are used to help prevent movement of the cervical spine and often are combined with lateral […]

Impact of POCUS During Cardiac Arrest Resuscitation on Compression Pauses

03 Aug
August 3, 2017

The provision of high-quality compressions with minimal interruptions is central to the management of cardiac arrest. Along with defibrillation, high-quality compressions are the only interventions proven to improve patient-oriented outcomes. Recently, point-of-care ultrasound (POCUS) has gained greater use in cardiac arrest care for determination the cause of arrest as well as guiding the resuscitation and […]

Balanced vs Unbalanced Fluids in Pediatric Severe Sepsis

27 Jul
July 27, 2017

Background: Fluid resuscitation with crystalloid is one of the most basic initial management approaches to adult and pediatric patients with severe sepsis and septic shock. However, which fluid should we be giving, and does it matter?  Should we give an unbalanced, chloride rich solution such as normal saline or a balanced, chloride restrictive fluid, such […]

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