We continue the series with Knowledge Bomb #20. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background Cerebral edema is one of the most feared complications in pediatric patients with diabetic ketoacidosis (DKA). It is the leading cause of death from this disease process. Thankfully
Association Between Therapeutic Hypothermia and Survival After In-Hospital Cardiac Arrest. Chan, Paul et al. JAMA. Oct 2016. [paper] Why I chose this study I recently rotated through the ICU and experienced multiple in-hospital cardiac arrests. There is research that suggests therapeutic hypothermia improves outcomes for out-of-hospital cardiac arrest. We were cooling patients with in-hospital cardiac arrest
We continue the series with Knowledge Bomb #19. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background Dyspnea and acute respiratory failure are among the top 5 reasons for patients to present to the Emergency Department. High-velocity nasal insufflation (HVNI), a type of high-flow nasal
Heart Failure for the Resuscitationist: The Basics I don’t have to tell you that heart failure is a common condition in the general population and in patients presenting to the emergency department (ED). We see it on a daily basis. Even with this familiarity there are still some conundrums in the care of these patients.
Preoxygenation With Flush Rate Oxygen: Comparing the Nonrebreather Mask With the Bag-Valve Mask Driver, Brian E et al. Annals of Emergency Medicine, March 2018. [paper] Why I chose this study While preoxygenating during rapid sequence intubation for spontaneously breathing patients, I’ve typically used bag valve mask (BVM) and nonrebreather mask (NRB) interchangeably. This is mainly based
We continue the series with Knowledge Bomb #18. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background It’s a busy ER shift. Everyone seems pretty sick today. You get a patient into a back room of your emergency department with a pretty bad nosebleed. The
Coronary Computed Tomography Angiography vs Functional Stress Testing for Patients with Suspected Coronary Artery Disease: A Systematic Review and Meta-analysis Foy, Andrew J, et al. JAMA Internal Medicine 2017. [paper] Why I chose this study Everything is still new and shiny as an intern, even acute chest pain. If the story is good and the
Derivation and Validation of a Novel Prediction Model to Identify Low-Risk Patients With Acute Pulmonary Embolism Subramanian, M. et al. The American Journal of Cardiology 2017. [paper] Why I chose this study The topic of discharging patients with pulmonary embolism (PE) came up in conversation recently. I started asking fellow residents if they have ever
The Impella CP Device for Acute Mechanical Circulatory Support in Refractory Cardiac Arrest Vase H, Christensen S, Christiansen A, et al. Resuscitation 2017. [paper] Why I chose this study While perusing LITFL R&R I stumbled on this interesting study. As we have started seeing with increased use of ECMO and the development of tools such as
Feeling Argumentative In this series we are going to pick apart the arguments and evidence surrounding a common but controversial topic in Emergency Medicine. The goal is to take a hard look at the practices we are handing down to future generations of ED docs and see what is based on opinion and what is
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