Critical Care

We Have No Beds: Ventilator Series

We Have No Beds: Ventilator Series Noninvasive Ventilation Part 1 It’s a busy night in the ED and in comes… …a 60 y/o male with OSA and COPD in extremis, sitting up on the gurney gripping the side rails, huffing and puffing, struggling to breathe.  You are informed that he has not used his CPAP in

EM/IM Sessions

Journal Club: Medical Error–The Third Leading Cause of Death in the US

Makary, Martin A., and Michael Daniel. “Medical Error Third Leading Cause of Death in the US.” Bmj 353 (2016): I2139. Print. PMID: 27143499 Wheww.  That’s quite the title. 3rd leading cause of death?? Really? Background: The CDC puts together their list of most common causes of death and this determines health policy. Money and awareness is

EM/IM Sessions

Journal Club: Addition of Indapamide to Frusemide Increases Natriuresis and Creatinine Clearance, but not Diuresis, in Fluid Overloaded ICU Patients.

Bihari, Shailesh, Andrew W. Holt, Shivesh Prakash, and Andrew D. Bersten. “Addition of Indapamide to Frusemide Increases Natriuresis and Creatinine Clearance, but Not Diuresis, in Fluid Overloaded ICU Patients.” Journal of Critical Care 33 (2016): 200-06.  PMID: 26948252 Two caveats before we get started.  Frusemide in the title is not a misprint but rather the Australian

EM/IM Sessions

Journal Club: Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage

Qureshi MD, Adnan, et al. for the ATACH-2 Trial Investigators and the Neurological Emergency Treatment Trials Network. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. NEJM 10.1056/NEJMoa1603460. PMID:27276234 Background: Research and guidelines are limited in terms of specific goal blood pressure targets in patients who suffer intracranial hemorrhage, especially those with acute hypertensive responses. 

EM/IM Sessions

Journal Club: Naproxen with Cyclobenzaprine, Oxycodone/Acetaminophen, or Placebo for Treating Acute Low Back Pain

Friedman BW, Dym AA, Davitt M, et al. Naproxen With Cyclobenzaprine, Oxycodone/Acetaminophen, or Placebo for Treating Acute Low Back Pain – A Randomized Clinical Trial. Jama. 2015;314(15):1572–1580. PMID:1 Background I chose this topic because while it may not be the most exciting question, it is an important one. This is a question that I seem to

EM/IM Sessions

Journal Club: Trial of Continuous or Interrupted Chest Compressions During CPR

Nichol G, Leroux B, Wang H, et al. Trial of Continuous or Interrupted Chest Compressions during CPR. N Engl J Med. 2015:2203–2214. PMID:26550795 Background Quality chest compressions are one of the few things that have been shown to improve the chance of achieving return of spontaneous circulation  (ROSC) during cardiac arrest. They are often interrupted,