EM/IM Sessions

EM/IM Sessions: Assessing Fluid Responsiveness

Bentzer P, Griesdale DE, Boyd J, MacLean K, Sirounis D, Ayas NT. Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?. JAMA. 2016;316(12):1298-1309. [paper] Why I chose this article We ask this question for every critically ill patient who remains hypotensive after what we believe is adequate fluid resuscitation. Knowing techniques to reassess these

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: Andexanet Alfa for Reversal of Factor Xa Inhibitor Activity

Siegal DM, Curnutte JT, Connolly SJ, et al. Andexanet Alfa for the Reversal of Factor Xa Inhibitor Activity. N Engl J Med. 2015 Dec 17; 373 (25): 2413-24. PMID:26559317 Background Direct factor Xa inhibitors (apixiban, rivaroxaban, edoxaban) are the novel agents being used in the prevention of stroke in patients with non-valvular afib, secondary prevention of

HYFTF

High Yield for the Field (HYFTF) 1.7.16 – By Dr. John Purakal

A new year brings a new HYFTF! In this episode, Dr. Purakal reviews talks by Dr. Eric Krueger (Derm review), Dr. George Hughes-Strange (CHF Overview) and a journal club presentation of his own on The Heart Score.

EM/IM Sessions

Journal Club: Challenges with HS-Troponin Elevations

Article Everett BM. Troponin and Cardiac Events in Stable Ischemic Heart Disease and Diabetes. New England Journal of Medicine. 2015 Interest Elevated troponin levels in the ED and inpatient medicine create a challenge for the best treatment methods for patients. Do all patients with elevated troponin require inpatient admission? Does surgical intervention help with outcome

EM/IM Sessions

Journal Club: Lactate Clearance Is Flawed?

Article: Lactate clearance as a target of therapy in sepsis: a flawed paradigm. PE Marik. R Bellomo. OA Critical Care 2013 Mar 01;1(1):3 Why This Article? Though not a conventional journal review article the discussion is interesting and by a credible author (PE Marik; Early goal directed therapy). As for lactate, in both the Emergency