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The HEAT Trial – Acetaminophen in ICU Patients with Fever
Background: Acetaminophen (paracetamol) is commonly used to lower the temperature of patients with fever suspected to be causeed by an infection in both homes across the world and the hospital. There are, however, opposing theories to the utility of decreasing ...
The SPLIT Trial: Saline vs Plasma-Lyte Fluid Therapy
There has been a lot of debate over the recent years about the safety of crystalloid fluid therapy in acutely ill patients. Several observational studies have shown an increased risk of acute kidney injury (AKI) with the use of normal ...
The FELLOW Trial: An End to Apneic Oxygenation?
Background: Every year there are a handful of “game changing” publications that truly change how we care for our patients. One such paper was a paper by Scott Weingart and Richard Levitan in the Annals of Emergency Medicine in 2011 ...
REBEL Cast Episode 17: The All Thoracotomy Episode
Welcome to the October 2015 REBELCast, where Swami, Matt, and I are going to tackle a couple of topics in the world of Trauma, specifically ED Thoracotomy. Now we all know that ED thoracotomy is a last ditch salvage effort, performed under ...
Got FOAM?
I recently gave a talk at my old alma mater (Texas A&M College of Medicine) on creating a Professional and Scholarly Community with FOAM in early September of 2015. One of the things I was most amazed by was how ...
The Modern Day Superhero
I was recently invited by Rick Body and Natalie May to speak at the Royal College of Emergency Medicine (RCEM) Meeting in Manchester, England, September 2015. The topic was “The Essence of Emergency Medicine.” I was allotted 20 minutes to ...
Catheter Directed Thrombolysis: The Magic Bullet for Submassive Pulmonary Embolism?
Background: When evaluating therapeutic options for PE, there are three categories in my mind: Subsegmental, Submassive, and Massive. For simplicity sake lets just say subsegmental PEs get treated with anticoagulation and massive PEs get treated with thrombolysis. The submassive category ...
Time to Antibiotics in Sepsis: A Metric Not Supported by “High Quality” Evidence
Background: Some of the major take home points from the sepsis trilogy of studies recently published (ProCESS, ARISE, and ProMISe) was that early identification of patients with sepsis, early intravenous fluids, and timely, appropriate broad-spectrum antibiotics is key to decreasing ...
The REVERT Trial: A Modified Valsalva Maneuver to Convert SVT
Background: In patients with cardiovascularly stable supraventricular tachycardia (SVT), the valsalva maneuver is recommended as an initial maneuver to help with cardioversion. The success rate of the valsalva maneuver alone is documented at 5 – 20%. The next option for ...
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