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- Head, Eye, Ear, Nose, and Throat
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The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury
Background: Ventilator-associated pneumonia (VAP), or what the CDC recently renamed infection-related ventilator-associated complication (IVAC), is defined as a nosocomial pneumonia occurring on day 3 of mechanical ventilation that was preceded by 2 days of stable or decreasing ventilator requirements.1, 2 ...
Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia (MINT Trial)
Background: Concurrent anemia worsens outcomes in patients that present with acute myocardial infarctions. Transfusions increase the oxygen carrying capacity of blood which can improve the perfusion of at-risk cardiac tissue. However, transfusions are also associated with immunosuppression, thrombotic phenomena, volume ...
Another Study on Peripheral Vasopressors
Background: Use of vasopressors is a common practice to support hemodynamics and optimization of tissue perfusion in patients presenting with shock. Historically the administration of vasopressors was restricted to central venous catheters (CVC) due to concerns for local tissue injury ...
The NICO Trial: NIV in Comatose Patients with Acute Poisoning
Background: Patients with decreased level of consciousness due to alcohol, drugs, or medications commonly present to the ED. These patients can be at risk of vomiting and aspiration and often prompts clinicians to pursue definitive airway management to avoid pneumonia ...
Clinical Conundrums: Do We Need to Order a CT for Every Patient with Renal Colic?
Bottom Line Up Top: In selective patients presenting with flank pain, we can diagnose renal colic without a CT scan. There is also a subset of patients that would benefit from IV contrast enhanced CT scanning. Clinical Scenario: A 35-year-old ...
Non-Invasive Blood Pressure Monitoring in Critically Ill Adults?
Background: Patients with shock frequently present with hypotension. Many of these patients are started on vasopressor and inopressor medications to assist in efforts to normalize blood pressure to help improve organ perfusion. In shocky patients, arterial lines are often used ...
REBEL Core Cast 117.0 – Infections of Pregnancy
Take Home Points Infections are a leading cause of maternal mortality worldwide. Prompt recognition is critical in management. Most infectious processes will require admission and close observation for improvement or decompensation.
The Needle Vs. The Knife for Spontaneous Pneumothorax: A Closer Look at the EXPRED Study
Background: The optimal management of primary, spontaneous pneumothorax (sPTX) remains an area of active debate. The British Thoracic Society recommends the least invasive approach possible. In contrast, the American College of Chest Physicians favors first-line chest tube drainage for any ...