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BICARICU-2: Should We Be Giving Bicarbonate in Septic Shock with Severe Metabolic Acidosis?

Medical providers have debated whether sodium bicarbonate should be used to correct this acidosis. The theorized physiological benefit is straight forward: raise the pH, improve hemodynamics, and stabilize the patient. The earlier BICARICU‑1 trial suggested a possible benefit in patients ...

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Endocrine, Metabolic, Fluid, and ElectrolytesResuscitation
Illustration of central retinal artery occlusion (CRAO) highlighting arterial obstruction and the role of thrombolysis.

Clinical Conundrum — What is the Role of Thrombolysis in Central Retinal Artery Occlusion?

While CRAO is often called an "eye stroke," current evidence does not support routine thrombolysis. Recent randomized trials, such as THEIA and TenCRAOS, show no visual benefit over aspirin and potential safety risks. Emergency management should focus on rapid diagnosis ...

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Head, Eye, Ear, Nose, and Throat

Safety and Efficacy of an Accelerated Troponin Protocol For Evaluation of ACS

Does primary sedation with dexmedetomidine or clonidine reduce the time to successful extubation in mechanically ventilated critically ill patients compared to propofol-based sedation?

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Cardiovascular

REBEL MIND – The One-Minute Preceptor: Making Every Patient Encounter a Teaching Opportunity

Welcome back to Rebel MIND, the podcast where we sharpen the person behind the practitioner. This series emphasizes productivity, provider performance, and team optimization to ensure we are at our best during high-pressure situations. The One-Minute Preceptor isn't just a ...

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Human BehaviorTeam Performance
HINTS vs Sudbury Vertigo Risk Score title graphic featuring a brain and inner-ear illustration.

MDCalc Wars: HINTS vs Sudbury Vertigo Risk Score — Which Tool Fits the Dizzy Patient?

HINTS or the Sudbury Vertigo Risk Score? Learn when to use each tool for the dizzy patient, why patient selection and HINTS training matter, and which pitfalls can lead to missed serious diagnoses.

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Neurology

The A2B Trial: Are Alpha-2 Agonists Better than Propofol for ICU Sedation?

Does primary sedation with dexmedetomidine or clonidine reduce the time to successful extubation in mechanically ventilated critically ill patients compared to propofol-based sedation?

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Neurology

Revisiting a Core Practice: Antibiotic Prophylaxis in Cirrhotic Bleeds

In adults with cirrhosis and upper gastrointestinal bleeding, does shorter‑duration or no antibiotic prophylaxis, compared with longer‑duration prophylaxis, lead to better clinical outcomes such as reduced mortality, infection, or adverse events?

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Abdominal and Gastrointestinal

REBEL MIND – The Nature Reset

Welcome back to Rebel MIND, the podcast where we sharpen the person behind the practitioner. MIND stands for Mastering Internal Negativity during Difficulty. This series emphasizes productivity, provider performance, and team optimization to ensure we are at our best during ...

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Human BehaviorTeam PerformanceWell-being

MDCalc Wars: Pediatric Appendicitis – Three Scores, One Diagnosis

Compare the strengths, limitations, and ideal use cases of Alvarado, PAS, and pARC to choose the right appendicitis score for your next pediatric patient.

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Pediatrics

Effect of Sepsis Bundle (SEP-1) Compliance and Implementation on Mortality

Is there any moderate or high-level evidence that SEP-1 compliance and/or implementation is associated with improvement in sepsis mortality?

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Infectious DiseaseResuscitation
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Illustration of central retinal artery occlusion (CRAO) highlighting arterial obstruction and the role of thrombolysis.
Oct 19
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HINTS vs Sudbury Vertigo Risk Score title graphic featuring a brain and inner-ear illustration.
Sep 28
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