Archive for category: Critical Care

April 2015 REBELCast

06 Apr
April 6, 2015

Welcome to the April 2015 REBELCast, where Swami, Matt, and I are going to tackle a couple of articles just published this year. Today we are going to specifically tackle: Topic #1: Basic Life Support (BLS) vs Advanced Cardiac Life Support (ACLS) in Out of Hospital Cardiac Arrest (OHCA) Topic #2: PROMISE Trial – Anatomic vs […]

The Protocolised Management in Sepsis (ProMISe) Trial

17 Mar
March 17, 2015

Since 2002, the surviving sepsis campaign (SSC) has stated that best practice in sepsis care includes: early recognition, source control, appropriate/timely antibiotic therapy, resuscitation with intravenous fluids (IVF) and vasoactive medications. Resuscitation of the septic patient in the emergency department has been largely based off the 2001 Rivers trial. This single center study’s focus was […]

The New Age of Sepsis Management

16 Mar
March 16, 2015

There are more than 750,000 cases of severe sepsis and septic shock in the US each year.  Most patients who present with sepsis receive their initial care in the emergency department.  In 2001, there was a landmark study by Rivers et al that reported that among patients with severe sepsis or septic shock mortality was […]

Beyond ACLS: Epinephrine in Out-of-Hospital Cardiac Arrest Poll

15 Mar
March 15, 2015

Recently, I wrote a post on the use of epinephrine in out-of-hospital cardiac arrest (OHCA) and this triggered some interesting discussion on twitter. Are we at a point that we can just stop using epinephrine in OHCA?  Has anyone stopped actually using epinephrine in OHCA and if so, why or why not? The evidence seems […]

Beyond ACLS: Is It Time to Abandon Epinephrine in Out-Of-Hospital Cardiac Arrest?

11 Mar
March 11, 2015

Epinephrine is widely used and recommended by Advanced Cardiovascular Life Support (ACLS) in out-of-hospital cardiac arrest (OHCA), but its effectiveness in neurologic outcomes has never been truly established.  To verify effectiveness of epinephrine confounders, such as patients, CPR quality, CPR by bystanders, time from call to arrival at scene or hospital, and much much more, […]

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