EM/IM Sessions

EM/IM Sessions: Effect of Occupancy on Critically Ill Admissions

Effect of Emergency Department and ICU Occupancy on Admission Decisions and Outcomes for Critically Ill Patients Kusum S. Mathews et al. Critical Care Medicine. May 2018. [paper] Why I Chose This Study “We have no beds, the MICU is now down to our crash bed” It seems all too frequent that we hear those dreaded

EM/IM Sessions

EM/IM Sessions: HFNC for Bronchiolitis

A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis Franklin, Donna, et al. The New England Journal of Medicine, March 2018. [paper] Why I Chose this Study During my recent PICU and Pediatric ED rotation, a large amount of my patients with bronchiolitis were started on HFNC liberally. Other hospitals that we rotate

EM/IM Sessions

EM/IM Sessions: SALT-ED Trial

Balanced Crystalloids versus Saline in Noncritically Ill Adults WH Self et al. New England Journal of Medicine, March 2018. [paper] Why I chose this article This article is another flashpoint in the long debate – typically between internists and surgeons – regarding the use of normal saline versus balanced crystalloids for resuscitation. I remember being

EM/IM Sessions

EM/IM Sessions: ED Efficiency

Key High-Efficiency Practices of Emergency Department Providers: a Mixed-Methods Study. Morgan R. Bobb et al. Society for Academic Emergency Medicine, Dec 2017. [paper] Why I chose this study Efficiency matters, and not just for the physician. Efficiency has a profound impact on patient care and patient outcomes. We all have heard of (or perhaps have

EM/IM Sessions

EM/IM Sessions: Hypothermia for In-Hospital Cardiac Arrest

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

EM/IM Sessions

EM/IM Sessions: Preoxygenation with Flush Rate O2

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

EM/IM Sessions

EM/IM Sessions: Coronary CTA vs Stress Testing

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

EM/IM Sessions

EM/IM Sessions: HOPPE Score for Low-Risk Pulmonary Embolism

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

EM/IM Sessions

EM/IM Sessions: Impella for Refractory Cardiac Arrest

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

An Abscess Worth Packing

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