Keeping the Beat

Keeping the Beat

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.

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: 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

EM/IM Sessions

EM/IM Sessions: YEARS Clinical Decision Tool for PE

Simplified Diagnostic Management of Suspected Pulmonary Embolism (the YEARS study): a Prospective, Multicentre, Cohort Study. van der Hulle, Tom, et al. The Lancet 2017 . [paper] Why I chose this study Determining if a patient has a pulmonary embolism (PE) is a routine occurrence in the emergency department (ED) and on the medicine inpatient service. I

Critical Care

We Have No Beds: Ventilator Series

We Have No Beds: Ventilator Series Assist Control So now that we have discussed how to read a ventilator screen, let’s discuss our first mode of ventilation… Assist Control (AC) This mode has the ability to completely control the patients ventilatory status. With this mode you set the rate, the means by which tidal volume is

EM/IM Sessions

EM/IM Sessions: Risk of AKI after IV Contrast

Risk of Acute Kidney Injury After Intravenous Contrast Media Administration Hinson, et al.  Annals of Emergency Medicine 2017. [paper] Why I chose this study On almost a daily basis, whether on Emergency or Internal Medicine, we all face a difficult question: “can this patient tolerate IV contrast administration for CT scan?” We are often guided

EM/IM Sessions

EM/IM Sessions: Acute MI After Influenza

Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection Kwong, JC et al. NEJM 2018. [paper] Why I chose this article In IM and EM, we are on the front lines of acute epidemics.  This year’s flu season has been a bad one and we are seeing a lot of generic flu but also complications and deaths

EM/IM Sessions

EM/IM Sessions: Treating Acute Low Back Pain

Naproxen with Cyclobenzaprine, Oxycodone/Acetaminophen, or Placebo for Treating Acute Low Back Pain: A Randomized Clinical Trial. Friedman, BW,  et al, JAMA 2015. [paper] Why I chose this article 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 deal

EM/IM Sessions

EM/IM Sessions: VANISH Trial

Effect of Early Vasopressin vs Norepinephrine on Kidney Failure in Patients With Septic Shock: The VANISH Randomized Clinical Trial. Gordon, AC, et al. JAMA 2016 [paper] Why I chose this article The kidney is painfully fragile, often one of the first organs to fail in septic shock. According to the last several iterations of the Surviving Sepsis Campaign Guidelines,