Archive for category: Clinical

Topical TXA in Epistaxis

07 Dec
December 7, 2017

Background: Epistaxis is a common Emergency Department (ED) complaint with over 450,000 visits per year and a lifetime incidence of 60% (Gifford 2008, Pallin 2005). Standard anterior epistaxis treatment consists of holding pressure, use of local vasoconstrictors, topical application of silver nitrate and placement of an anterior nasal pack. ED patients with epistaxis often fail conservative […]

Bacterial Endocarditis

04 Dec
December 4, 2017

Background: Definition Infective Endocarditis (IE) = Inflammation of the endothelium of the heart, heart valves (or both) (Osman 2013) Epidemiology Annual incidence = 5-7 cases per 100,000 (Fraimow 2013) 40,000 to 50,000 new cases in the US per year. Average hospital charges in excess of $120,000 per patient (Bor 2013) Slightly higher male predominance (1.5:1 […]

Door to Furosemide (D2F) in Acute CHF…Really?

27 Nov
November 27, 2017

Background: Acute congestive heart failure (AHF) is a common complaint seen in the ED and associated with a high morbidity, mortality, cost, and resources.  Many patients with AHF, ultimately end up being admitted and interventions in the ED can make a huge difference in the outcomes of these patients.  The REALITY-AHF (Registry Focused on Very […]

It’s Time for Tranexamic Acid (TXA) in Massive Hemorrhage

20 Nov
November 20, 2017

Background: Bleeding from massive hemorrhage in trauma and post-partum are a major cause of death worldwide. There have been two large randomized controlled trials, in trauma and post-partum hemorrhage that have shown administration of TXA within 3 hrs of bleeding onset reduces death due to bleeding. The current meta-analysis that we are going to review […]

Spontaneous Bacterial Peritonitis

16 Nov
November 16, 2017

Definition: Acute infection of the ascitic fluid in a patient with liver disease without another source of infection Epidemiology: (Runyon 1988, Runyon 1988, Borzio 2001) Incidence 10-25% risk of at least one episode per year 20% risk in those with ascites admitted to the hospital Historically, mortality ~ 50%

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