PEARL: Antipyretics (NSAIDS or acetaminophen) are not associated with improved 28-day ICU mortality in septic patients. CONTEXT: Septic patients often have fevers. Someone always wants to lower the fever with acetaminophen. For conscious, n…
Aspirin and Head Trauma: More Dangerous Than You Think B.L.U.F: In one retrospective study of patients who fell from standing, aspirin was associated with double the rate of traumatic ICH compared to warfarin use. CONTEXT: We know to treat…
Article Citation: Holzer M, et al. “Mild Therapeutic Hypothermia to Improve the Neurologic Outcome After Cardiac Arrest”. The New England Journal of Medicine. 2002. 346(8):549-556. What we already know about the topic: prelim st…
Article Citation: Stiell IG, Wells GA, Vandemheen KL, Clement CM, et al. The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA. 2001 Oct 17;286(15):1841-8. What we already know about the topic: More than a mill…
We have all encountered patients with Afib with RVR who require rate control and the question always is…..what drug? Some people prefer CCB like diltiazem while others prefer beta blockers like labetalol. Is one better than the other…
Here is a familiar scenario…..You need an emergent CT with IV contrast- whether it’s a trauma patient or a stroke patient or PE or dissection and you just don’t have the time to wait for a creatinine. Are you going to harm…
Article Citation: Johnston SC, Rothwell PM, Nguyen-Huynh MN, Giles MF, et al. Validation and refinement of scores to predict very early stroke risk after transient ischaemic attack. Lancet. 2007;369(9558):283-92. What we already know about…
Article Citation: Kline JA, et al. “Prospective multicenter evaluation of the pulmonary embolism rule-out criteria”. J Thromb Haemost. 2008. 6(5):772-780. What we already know about the topic: PERC (Pulmonary Embolism Rule-out C…
Title: “The 52 in 52 Review: Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock” Article Citation: Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock. Emanuel Rivers, M.D…
So now that the biggest nature-themed event of 2017 is finished, we can all throw our rad NASA certified eclipse goggles into a drawer until 2024, when the next eclipse is due, and move on with our lives. Correct? Wrong. Natur…
You’re in the middle of a busy Resus shift, no available beds, and someone asks you if they can bring back a patient for a procedural sedation to reduce a dislocated shoulder. “Arghhhhghgh” you think to yourself, “just what I need.” Tons of…
Article Citation: William H. Bickell, Matthew J. Wall, Jr., Paul E. Pepe, R. Russell Martin, Victoria F. Ginger, Mary K. Allen, and Kenneth L. Mattox. Immediate versus Delayed Fluid Resuscitation for Hypotensive Patients with Penetrating To…
Few would argue that Gastroparesis (or, delayed gastric emptying) is in the pantheon of coolest topics in EM these days, and for good reason. Affecting diabetics, chronic marijuana users, long-term smokers, this disease causes the un…
You are quietly typing away at your computer when the familiar (but not entirely pleasant) sound of retching fills the air. You look out onto the side and see a young woman dry-heaving into a pink plastic bucket, looking miserable. This per…
Did you ever wonder how your automatic blood pressure cuff actually works? No? Just me? Well…no surprise there. When the machine inflates the cuff, its goal is to get it above the patient’s systolic blood pressure (table how it…
