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Should You Prescribe Oral Thiamine for Chronic Alcoholics?

Background: Alcoholism is a chronic disease with a staggering impact on society, costing the nation approximately 100 billion dollars per year, an expenditure greater than the costs associated with all cancers and respiratory diseases combined (Whiteman 2000). Large public hospital emergency ...

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Toxicology

Button Battery Ingestion

Button Batteries: Small, disc shaped battery cells which are designed for use in small electronic devices. Common sources are kids toys, watches, calculators and hearing aids. Most batteries use lithium as a power source Button Battery Ingestion Danger: Contact with ...

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Pediatrics

Safety of PE Treatment with Rivaroxaban

Background: The simplified PE Severity Index (sPESI) is one of several validated prognostic tools for acute pulmonary embolism (PE).  The European Society of Cardiology recommended the use of the sPESI to risk-stratify patients with acute PE into low risk (sPESI=0) and ...

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Thoracic and Respiratory

ATHOS-3: A New Vasopressor For Treatment of Vasodilatory Shock?

Background: As I walk to the bedside to re-examine my patient with refractory hypotension, I start thinking what else can I do? My patient came into the hospital with septic shock secondary community acquired pneumonia requiring me to intubate her due ...

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Resuscitation

Pacemaker Basics

Have you ever been confused by the alphabet soup of pacemakers? This post will serve as a pacemaker basics reference.

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Cardiovascular

The ENDAO Trial: Is Apneic Oxygenation a Futile Intervention in ED RSI?

Background: One of the most feared complications associated with rapid sequence intubation (RSI) is hypoxemia ultimately leading to cardiac arrest.  The FELLOW Trial, a recent randomized controlled trial demonstrated no difference in hypoxemia rates between patients that received apneic oxygenation ...

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Resuscitation

The Utility of Amiodarone in Cardiac Arrest – Systematic Review and Meta-Analysis

Background: In 2016 the annual incidence of out-of-hospital cardiac arrest (OHCA) in the United States was roughly 360,000 and 209,000 for in-hospital cardiac arrest (IHCA) (Mozaffarian 2016). Though survival rates are relatively dismal, arrests in the setting of shock amenable ...

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Resuscitation

Spinal Immobilization in Trauma Patients

Background: It has been common practice in trauma to place patients in cervical collars and on long backboards (LBBs) to achieve spinal immobilization. LBBs are used to help prevent spinal movement and facilitate extrication of patients. Cervical collars (C-Collars) are ...

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Trauma

Impact of POCUS During Cardiac Arrest Resuscitation on Compression Pauses

The provision of high-quality compressions with minimal interruptions is central to the management of cardiac arrest. Along with defibrillation, high-quality compressions are the only interventions proven to improve patient-oriented outcomes. Recently, point-of-care ultrasound (POCUS) has gained greater use in cardiac ...

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Resuscitation

Balanced vs Unbalanced Fluids in Pediatric Severe Sepsis

Background: Fluid resuscitation with crystalloid is one of the most basic initial management approaches to adult and pediatric patients with severe sepsis and septic shock. However, which fluid should we be giving, and does it matter?  Should we give an ...

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Pediatrics
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