Archive for category: Clinical

The DETO2X Trial: Do Patients with AMI Need Supplemental O2?

21 Sep
September 21, 2017

Background: Each year approximately 790,000 Americans suffer an acute myocardial infarction (AMI) (Benjamin 2017). Traditional treatment for an acute myocardial infarction has included morphine, oxygen, nitroglycerine and aspirin (MONA) with interventions such as percutaneous coronary intervention providing more definitive management. There has been little data from randomized control studies that supports the use of oxygen […]

Can We Agree on Cardiac Standstill?

18 Sep
September 18, 2017

Background: Point of Care Ultrasound (POCUS) has gained wider use in resuscitation of patients presenting with cardiac arrest. POCUS can play an important role in determining the etiology of arrest as well as being used to determine the presence or absence of mechanical activity. The REASON study demonstrated that patients with PEA or asystole without […]

Turn it (All the Way) Up: Flush Rate O2 for Pre-Oxygenation

14 Sep
September 14, 2017

Background: There has been a lot of buzz recently about the importance of pre-oxygenation in emergency airway management.  The recent publication of the ENDAO trial [2], a randomized clinical trial of ApOx vs no ApOx also emphasized this point.  In the review article accompanying this trial by John Sackles [3] he brought up the point […]

Predicting Dysrhythmias After Syncope

11 Sep
September 11, 2017

Background: Syncope, the sudden, brief loss of consciousness followed by spontaneous, complete recovery is a common presentation to the Emergency Department (ED). It represents a significant portion of overall admissions to the hospital because while many cases are benign (i.e. vasovagal syncope), some may result from a life-threatening cause (ventricular tachydysrhythmia, myocardial ischemia, gastrointestinal bleeding […]

Should You Prescribe Oral Thiamine for Chronic Alcoholics?

07 Sep
September 7, 2017

Background: Alcoholism is a chronic disease with a staggering impact on society, costing the nation approximately 100 billion dollars per year, an expenditure greater than the costs associated with all cancers and respiratory diseases combined (Whiteman 2000). Large public hospital emergency department studies have demonstrated the enormous strain of alcohol use on resources, and the disproportionate […]

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