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All Categories
  • All Categories
  • Abdominal and Gastrointestinal
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  • Thoracic and Respiratory
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  • Trauma

FLORALI-2: Non-Invasive Ventilation (NIV) vs High-Flow Nasal Cannula (HFNC) as Pre-Oxygenation Prior to Intubation

Background:Tracheal intubation is a common procedure performed on critically ill patients. In these patients, there is a high risk of life-threatening complications associated with the procedure, with severe hypoxemia being one of the more common. Development of severe hypoxemia, in turn, ...

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Resuscitation

Endovascular Therapy for Acute Ischemic Stroke: The New Shiny Toy in Stroke Care?

The shiny new toy in stroke treatment is endovascular therapy.  There have now been 12 randomized controlled trials (RCTs) on endovascular stroke therapy (EST), with eight of the last nine showing positive results – stunningly positive.  This flood of positive ...

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Neurology

Tramadol or Tramadont

Background: Multiple guidelines recommend tramadol or NSAIDs as 1stline treatment for patients with osteoarthritis (OA).  Tramadol is viewed as a weak opioid because it binds to the mu receptor at a significantly lower affinity than morphine.It also inhibits the reuptake of serotonin ...

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Trauma

Contrast Induced Nephropathy: A Modern-Day Medical Myth

Background: Computed tomography (CT) scans using IV contrast agents are one of the most common imaging modalities used in the emergency department (ED). The reason for this is no secret. CT scans with IV contrast offer a large amount of information ...

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Renal and Genitourinary

REBEL Core Cast 8.0 – The NEJM + Non-Inferiority Studies

Take Home Points on Non-Inferiority Studies Non-inferiority studies should be done when a new treatment (or diagnostic modality) requires less resources (cost or time), is easier for the patient or has a lower side-effect profile. Non-inferiority study design largely negates ...

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Extending the tPA Window to 4.5 – 9 Hours in Acute Ischemic Stroke (AIS)?

Background: No matter which side of the debate you sit on in regard to systemic thrombolysis in acute ischemic stroke (AIS), there is one truth: systems have undergone major changes to ensure tPA is offered to patients in the ≤4.5-hour window.  ...

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Neurology

Critical Care Controversies: The REBEL vs The SKEPTIC at #SMACC 2019

On the last day of the last SMACC conference, Dr. Ken Milne (The SGEM) and I had a cage match debating four critical care controversies. It was all done in good fun with both of us taking our opportunities to ...

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NeurologyProcedures and SkillsResuscitation

Pulse Checks in Cardiac Arrest Should be Dead

Background: In an older study published in Resuscitation 1998 , ED physicians, ICU physicians, and nurses tried to identify a carotid pulse in a healthy male volunteer with normal blood pressure. 43.1% of the health professionals required >5 seconds to detect the ...

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Resuscitation

Tranexamic Acid (TXA) for Everything that Bleeds?

Background: TXA is a synthetic lysine derivative that binds with the lysine site on plasminogen and inhibits fibrinolysis.  TXA is not a new drug. Studies from the late 1960s and early 1970s have shown reduced bleeding and need for transfusions in ...

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Hematology and Oncology

JC: Time to put the REBOA Balloon Away? Maybe, Maybe Not…

The management of the critically hemorrhaging trauma patient has seen a large amount of change over last decade, from bringing care far forward to the field to early use of blood products to civilian translation and application tourniquets to name a ...

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Trauma
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