Archive

Author: Rob Bryant

AVERT-Shock: Vasopressin for Acute Hemorrhage?

You are working at a Level 1 Trauma Center; a 35-year-old female arrives via EMS from the scene of a motor vehicle accident. She was an unrestrained passenger, ejected 50 feet. She was hypotensive and hypoxic on scene with concern …

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ResuscitationTrauma

Does Head of Bed Elevation During Intubation Improve Patient Oriented Outcomes?

You are working an ED shift with an experienced EM resident. As the resident prepares to intubate a 100kg patient with pneumonia you suggest that the head of the bed be elevated to aid in first pass success and avoidance …

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Procedures and Skills

Pediatric Push Dose Epinephrine: Getting the Epi Dose Right During Pediatric Resuscitation

Warning: Limited Published Evidence on this Topic You have just intubated a 4 year old with sepsis from a bad pneumonia. Post intubation BP is 70 systolic, while waiting for the epinephrine (adrenaline) infusion to come up from pharmacy you …

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PediatricsResuscitation

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 …

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Resuscitation

Abscess Management: The Reformation of an Antibiotic Nihilist

Abscess management has evolved somewhat in the 14 years since my residency graduation. The point at which antibiotics are likely to be more helpful than harmful is not always easy to assess, and evidence based expert opinion has flip flopped …

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Infectious Disease

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