Archive for category: Clinical

Why we Should Consider Not Using Morphine in Acute Heart Failure

02 Aug
August 2, 2018

Background/Introduction: Acute heart failure is a common diagnosis encountered among patients presenting to the Emergency Department with complaints of shortness of breath. The emergency treatment of these patients has traditionally focused on alleviation of their symptoms of breathlessness and anxiety in addition to optimization of hemodynamics and rapid reduction in both preload and afterload. The treatment […]

TICH-2: TXA for Spontaneous ICH?

30 Jul
July 30, 2018

Background: Spontaneous, non-traumatic intracerebral hemorrhage, is one of the only stroke subtypes without a proven treatment. It is not as common as ischemic stroke, representing up to 20% of all strokes, but it accounts for almost half of all stroke deaths worldwide.  Furthermore, about a quarter of intracerebral hemorrhage can be complicated by hematoma expansion which can […]

Procalcitonin: Useful Test or Useless Pest to Improve Antibiotic Stewardship with Acute Respiratory Infections in the ED?

27 Jul
July 27, 2018

Background: In patients with an acute respiratory illness (ARI), it is often difficult to determine whether a bacterial infection is the underlying etiology and whether antibiotics are warranted. Excess antibiotic use carries risk of bacterial resistance, medical costs, and adverse drug effects. However, underuse of antibiotics risks inadequate treatment and progression of disease. In the setting […]

REBEL Cast Ep57 – Cardiac Arrest Sonographic Assessment (CASA) with Lead Author Kevin Gardner, MD

25 Jul
July 25, 2018

Background: In the ED, POCUS has become one of the most important tools in discovering both the diagnosis and in the management of critically ill patients.  cardiac arrest, is ultimately as sick as a person can get in the spectrum of critical illness.  I mean how can someone be deader than dead, right?  There has been […]

Is Macrobid Safe in 1st Trimester Pregnancy?

23 Jul
July 23, 2018

Background: In 2011, the American College of Obstetricians and Gynecologists (ACOG) released a committee opinion warning against the use of nitrofurantoin (Macrobid) during the first trimester of pregnancy due to the perceived risk of an increased rate of congenital abnormalities with its use (Committee Opinion 2017). While the committee continued to recommend that nitrofurantoin be […]

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