Archive for category: Clinical

Should I Stay or Should I Go: Outpatient Treatment of Venous Thromboembolism

05 Dec
December 5, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: The care of venous thromboembolism (VTE) is currently undergoing a paradigm shift in the US with an increasingly large percentage of patients being discharged home from the Emergency Department (ED).  It wasn’t too long ago that all patients diagnosed with deep vein thrombosis (DVT) and pulmonary embolism (PE) […]

Mythbuster: Glucose Levels Must be Below a “Safe” Threshold Before Discharge

01 Dec
December 1, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Anyone who works in the Emergency Department has seen patients brought in by EMS or sent from the clinic with a chief complaint of “high blood sugar.”  Now, we are not talking about patients with diabetic ketoacidosis, but just simple hyperglycemia. This is a common complaint with no […]

Does Targeted Temperature Management Actually Work?

28 Nov
November 28, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketThe use of therapeutic hypothermia (TH) has become part of the routine care of patients after return of spontaneous circulation (ROSC) from cardiac arrest (Use of the phrase Targeted Temperature Management has become more accepted). It became much more accepted after two separate trials were published in the New […]

Treatment of Submassive Pulmonary Embolism (PE): Full Dose, Half Dose, or No Dose?

03 Nov
November 3, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketSubmassive pulmonary embolism (PE) is responsible for approximately 20% of all PEs.  Although the in-hospital mortality has been reported as about 5%, there is significant morbidity associated with this diagnosis such as chronic pulmonary hypertension, impaired quality of life, persistent right ventricular disfunction, and recurrent venous thromboembolism.  The literature […]

The HYPRESS Trial: Early Steroids to Prevent Septic Shock

31 Oct
October 31, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: The most recent surviving sepsis campaign recommends the use of hydrocortisone in patients with refractory septic shock (i.e. vasopressor dependent).  However, the use of hydrocortisone in severe sepsis without shock still remains a very controversial topic. Recommendations for hydrocortisone are mostly based on 2 randomized clinical trials (i.e. […]

Baclofen Withdrawal

27 Oct
October 27, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketDefinition: A dysfunctional condition in which removal of baclofen, an inhibitory neurotransmitter, from the central nervous system (CNS) causes CNS excitation.

The PESIT Trial: Do All Patients with 1st Time Syncope Need a Pulmonary Embolism Workup?

24 Oct
October 24, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Syncope is a very frustrating chief complaint for many in the medical field.  There is no gold standard test and no validated decision instrument. It represents about 3 – 5% of ED visits, 1 – 6% of hospital admissions, and in patients over the age of 65 years […]

American College of Emergency Physicians (ACEP) Conference 2016

20 Oct
October 20, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketThis years ACEP 2016 conference took place in Las Vegas, NV from Oct 16th – 19th.  There was greater than 350 courses, labs, and workshops given throughout the week.  It was impossible to make all of these great lectures, but I was able to take away some very important […]

Hyperthermia Syndromes

17 Oct
October 17, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketDefinition: A life-threatening emergency in which there is a failure of the body’s thermoregulatory mechanisms to handle extrinsic and intrinsic heat. The failure of thermoregulation leads to multi-system organ dysfunction characterized by alteration of neurologic function. Unlike in fever, hyperthermia is not caused by endogenous pyrogens that change the […]

October 2016 REBEL Cast: IDSA Pneumonia Update

10 Oct
October 10, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketEvery few years we get updates in the guidelines based on new evidence. Guidelines give us a framework to work with in the treatment of disease processes, such as pneumonia. The last Infectious Disease Society of America (IDSA) guidelines update on the treatment of pneumonia came from 2005, but […]

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