BICAR-ICU: How Should this Study Affect Care in the ED?
During a busy resuscitation it behooves the ED resuscitationist to avoid ordering therapies that have no clear benefit to their patients. Our nurses are overburdened, and adding interventions ‘just to be safe’ or ‘because we always do it’ is a great way to overwhelm our nursing colleagues. Bicarb administration is a contentious issue and many clinicians consider its use to fall firmly into the no-benefit camp, even when used in the management of severe metabolic acidosis. There have been no studies to date evaluating clinical outcomes with the use of sodium bicarbonate infusion therapy for severe metabolic acidemia, until now. This post is a review of the recently published BICAR-ICU trial Read more →
Background: Despite 
EM Journal Update: Safety of Using Wells’ Clinical Model With D-Dimer To Manage Patients In The ED With Suspected Pulmonary Embolism 
Background: 
Choosing Your Initial Settings: I hope you now see what physiologies to consider when setting up the ventilator and your goals for each. If your patient doesn’t fit into one of these three categories, then I set up my ventilator as if I was managing a patient who has refractory hypoxemia to maintain a lung protective strategy even if they don’t think they have very significant lung disease. Maintaining a lung protective strategy with low tidal volume ventilation has been shown to decrease ventilator induced lung injury and minimize harm, even in patients without refractory hypoxemia and ARDS (1-2). 
