Archive for category: Clinical

Bougie 1st Intubation in the ED?

19 Apr
April 19, 2018

Background: Successful first-pass endotracheal intubation is the desired outcome of all ER physicians as this can stave off hypoxemia and aspiration.  The bougie is one tool we have in our armamentarium that may be able to help with intubation. Many providers use this device as a rescue device after a failed attempt at intubation, instead of […]

The SIRS & qSOFA Confusion in Sepsis

16 Apr
April 16, 2018

Background: It is well established that the rapid identification of patients with sepsis is needed in order to initiate timely care to improve morbidity and mortality.  The systemic inflammatory response syndrome (SIRS) criteria have been used for some time for screening, however the sensitivity and specificity of these criteria have been brought to question based […]

REBEL Cast Ep 48: Octreotide and Somatostatin for Undifferentiated Upper Gastrointestinal Bleed

13 Apr
April 13, 2018

Recently I was asked to speak at the Texas College of Emergency Physicians (TCEP) conference April 2018.  The particulars of this session were, five, 10 minute lectures on new indications for old drugs.  My topic was the use of octreotide and somatostatin for undifferentiated upper gastrointestinal bleeding.  This is a particular topic I have been […]

Video Laryngoscopy (VL) Or Direct Laryngoscopy (DL) in the ED

12 Apr
April 12, 2018

Background:Endotracheal intubation is a common occurrence in the ED. Many patients requiring airway management are at a higher risk of hypoxia due to deranged respiratory physiology (i.e. decreased functional residual capacity and/or increased shunt fraction).  Advocates of video laryngoscopy argue that it provides better visualization of the airway anatomy, but it is less clear if […]

The PARIS Trial: HFNC in Infants with Bronchiolitis

09 Apr
April 9, 2018

Background: Bronchiolitis is an acute inflammatory injury of the distal smaller airways, most commonly caused by viral infections.  There have been a host of medications studied in the treatment of bronchiolitis, including steroids, albuterol, epinephrine, and  inhaled hypertonic saline, with none proving to be effective in treatment.  Oxygen therapy via high-flow nasal cannula (HFNC) as […]

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