Archive for category: Clinical

Video Laryngoscopy (VL) Or Direct Laryngoscopy (DL) in the ED

12 Apr
April 12, 2018

Background:Endotracheal intubation is a common occurrence in the ED. Many patients requiring airway management are at a higher risk of hypoxia due to deranged respiratory physiology (i.e. decreased functional residual capacity and/or increased shunt fraction).  Advocates of video laryngoscopy argue that it provides better visualization of the airway anatomy, but it is less clear if […]

The PARIS Trial: HFNC in Infants with Bronchiolitis

09 Apr
April 9, 2018

Background: Bronchiolitis is an acute inflammatory injury of the distal smaller airways, most commonly caused by viral infections.  There have been a host of medications studied in the treatment of bronchiolitis, including steroids, albuterol, epinephrine, and  inhaled hypertonic saline, with none proving to be effective in treatment.  Oxygen therapy via high-flow nasal cannula (HFNC) as […]

Utility of Antibiotics in Abscess Management – Systematic Review and Meta-Analysis

02 Apr
April 2, 2018

Background: Skin and soft tissue abscesses are a common emergency department (ED) presentation. The approach to management has changed little in recent decades: incision and drainage (I+D) and then discharge home with follow up. However, increasing rates of methicillin-resistant staph aureus (MRSA) over the last decade have led to further consideration of adjunct therapy with oral […]

APROCCHSS: More on Steroids in Septic Shock

29 Mar
March 29, 2018

Background: There have now been several trials published on the use of steroids in sepsis.  In 2002, we had the Annane Trial, with 299 patients showing mortality and shock reversal benefit in sepsis with hydrocortisone.  Then in 2008 we had the CORTICUS trial, with 499 patients, which found a faster reversal of shock, but no […]

Does it Take a VAN to Identify Emergent Large Vessel Occlusion (ELVO) in Ischemic Stroke?

27 Mar
March 27, 2018

Background: Over the last three years, we have seen the rise of neurointerventional therapies for patients with ischemic strokes due to large vessel occlusions (LVOs). This group of strokes typically includes patients with occlusion of the distal intracranial carotid artery, middle cerebral artery or anterior cerebral artery. Rapid identification of these patients both in the prehospital […]

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