Archive

Medical Category: Thoracic and Respiratory

Shifting the Paradigm: Can We Manage Mechanically Ventilated Patients with Occult Traumatic Pneumothorax Conservatively?

Background: Clinically significant pneumothoraces in patients on mechanical ventilation can be dangerous as positive pressure ventilation can cause an increase in intrapleural pressure and trigger tension physiology. Occult pneumothoraces are those not suspected clinically or not evident on plain radiographs ...

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Thoracic and RespiratoryTrauma

Impact of Emergency Department Crowding on Lung Protective Ventilation

Background Information: Obtaining definitive control of the airway, when indicated, is the responsibility of the emergency medicine physician. Traditionally patients were managed on the ventilator with lung volumes of 10 – 15 ml/kg. However, that practice is long-outdated and patients ...

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ResuscitationThoracic and Respiratory

The RAMPP Trial: Randomised Ambulatory Management of Primary Pneumothorax

Background: Primary spontaneous pneumothorax, by definition, occurs without trauma or any underlying lung pathology. Often patients are otherwise young and healthy. However, management continues to be debated and may lead to unnecessary hospitalization. Previous studies regarding ambulatory management included randomized ...

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Thoracic and Respiratory

Pigtail Catheter vs Large Bore Chest Tube for Pneumothorax

Background: Pneumothorax management is a common clinical condition in the emergency department (ED) occurring in patients of varying ages and caused by multiple etiologies, including spontaneous, traumatic, and iatrogenic pneumothorax. Regardless of the cause, a thoracostomy is often required for ...

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Thoracic and Respiratory

The BOX Trial: BP & O2 Targets in Comatose Survivors of Cardiac Arrest

Background: Hypoxemia and hypoperfusion are important factors in outcomes after ROSC.  While hypoxemia (SpO2 <90%) is clearly deleterious, it is unclear if hyperoxia is beneficial.  Recent studies on patients requiring critical care have demonstrated that hyperoxia is harmful and instead ...

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CardiovascularResuscitationThoracic and Respiratory

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