Recently, I wrote a post on the use of epinephrine in out-of-hospital cardiac arrest (OHCA) and this triggered some interesting discussion on twitter. Are we at a point that we can just stop using epinephrine in OHCA? Has anyone stopped actually using epinephrine in OHCA and if so, why or why not? The evidence seems to point to no "good" neurologic benefit over basic life support (BLS). I would love to hear more peoples thoughts on this....Read More
Epinephrine 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
Welcome to the March 2015 REBEL Cast, 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
According 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?
Cough 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