Beyond ACLS: Is It Time to Abandon Epinephrine in Out-Of-Hospital Cardiac Arrest?

11 Mar
March 11, 2015

epinephrineEpinephrine is widely used and recommended by Advanced Cardiovascular Life Support (ACLS) in out-of-hospital cardiac arrest (OHCA), but its effectiveness in neurologic outcomes has never been truly established.  To verify effectiveness of epinephrine confounders, such as patients, CPR quality, CPR by bystanders, time from call to arrival at scene or hospital, and much much more, must be controlled for in a trial. This type of study is not easily performed due to ACLS being the current standard of care. Read more →

March 2015 REBELCast

09 Mar
March 9, 2015

REBELCastWelcome to the March 2015 REBELCast, where Swami, Matt, and I are going to tackle a couple of topics that come up frequently in clinical practice in the emergency department. Today we are going to specifically tackle:

  • Topic #1: Oseltamivir (Tamiflu) in the Treatment of Influenza
  • Topic #2: Use of the HEART Score in Low Risk Chest Pain Patients Read more →

Video Laryngoscopy or Direct Laryngoscopy for Trainees

05 Mar
March 5, 2015

Glidescope Video LaryngoscopyAccording to a 2012 meta-analysis difficult and failed intubations in the operating room occur 1.8 – 5.8% and 0.13 – 0.30% of the time respectively. Emergent intubation, outside of this environment (i.e emergency department, ICU, and medical ward) is typically associated with a much higher risk of difficulty and complications due to many patients rapidly deteriorating. Recently, I had a discussion on twitter with Jeffrey Hill (@_drjeffy) and Taylor Zhou (@canibagthat) about what is the best way to teach trainees to intubate: Video Laryngoscopy (VL) or Direct Laryngoscopy (DL) for Trainees?

PLEASE BE SURE TO VOTE AT THE BOTTOM OF THIS POST!!!

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How Long Does a Cough From Respiratory Illness Last?

02 Mar
March 2, 2015

Cough and VirusCough from respiratory illness is one of the most common reasons that patients seek care in both the outpatient primary care setting and the emergency department (ED).  Cough due to respiratory illness is a self-limited condition in the majority of cases, but patients still seek care at clinics and EDs seeking relief or their symptoms. Maybe the reason for this is patients’ expectations of duration of cough and the actual natural history of cough from respiratory illness are mismatched. So how long does a cough from respiratory illness last? Read more →

Any Benefit to Adjunct Prednisone Therapy in Community Acquired Pneumonia?

18 Feb
February 18, 2015

PneumoniaBackground: Respiratory tract infections and pneumonia are the 3rd leading cause of death worldwide.  Although morbidity and mortality has improved slightly with the advent of antibiotics, there is still a significant long-term morbidity and mortality associated with this disorder.  It is well known that in pneumonia, there is an excess release of circulating inflammatory cytokines which cause further pulmonary dysfunction. Maybe the use of systemic corticosteroids, which have anti-inflammatory effects, could help attenuate this systemic inflammatory process and thus improve outcomes. So is there any benefit to adjunct prednisone therapy in community acquired pneumonia?

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