Archive for category: Clinical

High Flow Nasal Cannula (HFNC) – Part 1: How It Works

20 Aug
August 20, 2018

The use of heated and humidified high flow nasal cannula (HFNC) has become increasingly popular in the treatment of patients with acute respiratory failure through all age groups.  I first started using it as a pediatric intensive care fellow, but had little knowledge of how it actually worked.  I noticed a few years after using […]

Cervical Spine Evaluation and Clearance in the Intoxicated Patient

16 Aug
August 16, 2018

Background: Alcohol and drug intoxication is common in trauma patients and a significant proportion of cervical spine (c-spine) injuries occur in patients with intoxication. A standard approach to both intoxicated and sober patients with suspected c-spine injury in many trauma centers includes the placement of a rigid cervical collar for spinal immobilization until the c-spine can […]

Comparison of IM Midazolam, Olanzapine, Ziprasidone and Haloperidol for Behavioral Control

13 Aug
August 13, 2018

Background: Emergency providers frequently care for agitated patients ranging from restlessness to verbally and physically aggressive. Agitation is a symptom, not a diagnosis and these patients require careful evaluation to rule in or out serious medical conditions. Unfortunately, the agitation itself often obstructs this evaluation and places the patient, other patients and staff at risk. While […]

IV and/or Nebulized MgSO4 in Pediatric Asthma Exacerbations?

09 Aug
August 9, 2018

Background: Acute asthma exacerbations are a common presentation to pediatric emergency departments (EDs). Standard treatment with inhaled beta agonists and corticosteroids are often sufficient in mild asthma but can fall short in the treatment of moderate to severe exacerbations. Magnesium sulfate (MgSO4) has long been touted as an adjunct treatment due to its bronchodilatory properties (both […]

REBEL Cast Ep58 – Would you be SHoC-ED if POCUS did not Improve Clinical Outcomes in Patients with Undifferentiated Shock?

06 Aug
August 6, 2018

Background: POCUS has been touted as the stethoscope 2.0, a true game changer in patient care.  There is no patient population that this statement should hold more true for, than in patients with undifferentiated shock (SBP <100mmHg or SI > 1). Everyone has a story about how ultrasound changed their management or even saved a patient’s life. Unfortunately, […]

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