Noreversaban?
We have written about the new Non-Vitamin K Oral Anti Coagulants (NOACs). Many have jokingly referred to them as the “Noreversabans.” Taking these drugs is a high risk, high reward type of decision. While we recognize the benefits of quick anticoagulation without a need to bridge, as well as being more stable and having less interactions than Coumadin, these drugs are dangerous with serious bleeding concerns. Recently, Dabigatran was likened to “Dancing with the Devil”. For those of us in EM and Critical Care practice, there are no good options for reversing these agents. Once taken there is no turning back… until now?
Recently, I was asked to give a lecture to both my residents and nurses at the University of Texas Health Science Center at San Antonio (UTHSCSA) on some common DKA myths. Now this topic was originally covered by my good friend Anand Swaminathan on multiple platforms and I did ask his permission to create this blogpost with the idea of improving patient care and wanted to express full disclosure of that fact. I specifically covered four common myths that I still see people doing in regards to DKA management:
The newly published 2015 AHA guidelines recommend that:
Background: In cardiac arrest, high quality, uninterrupted CPR is essential to help improve survival rates. In theory, mechanical CPR should provide CPR at a standard depth and rate for prolonged periods without a decline in quality, which should help improve survival and survival with good neurologic outcomes. There are many types of mechanical chest compression devices but the two main technologies can be generalized as piston devices and load-distributing bands. The piston driven devices work by compressing on the chest in an up and down type of motion, similar to how we do manual CPR. The load distributing bands wrap all the way around the chest and shorten and lengthen which provides more of a rhythmic type of chest compression. No individual trials have ever shown superiority on clinically important outcomes for adult patients with OHCA, regardless of device. 
In case you have not heard or not read it on the twittersphere, the American Heart Association just released their 2015 Guidelines Update for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) in Circulation. I am joined by Mr. Security, Matt Astin for this episode and we both read through this massive 15 part document and came up with our top 5 updates and recommendations. Now this is just a list of our top 5 new or updated recommendations, that caught our attention, but certainly there are other recommendations. If you want the cliff notes version of the updates look through part I, titled the executive summary or the Highlights PDF which we will attach on the blog, but certainly as always we recommend reading the full document to form your own interpretations and opinions. 
