When, if ever, should we be giving bicarbonate in patients with metabolic acidosis? A study published in The Lancet in July 2018 involved a multicentre RCT in 26 ICUs with 400 patients, called the BICAR-ICU trial. It found that in severe acidemia (<7.2), sodium bicarbonate infusion compared with no infusion did not decrease mortality over […]
Zombie foot in need of repair
Posted onImagine your patient is minding his or her own business when their foot gets crushed by a bus. This totally hypothetical occurrence is only one of an infinite number of examples of situations that could result in a complex wound(s) needing repair. For wounds on the soles of the feet, adequate anesthesia via local infiltration […]