Prehospital Airway Management
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There was no clear winner between bag valve mask, supraglottic airway, or endotracheal intubation when patients needed ventilatory support or airway protection in the prehospital setting.
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There was no clear winner between bag valve mask, supraglottic airway, or endotracheal intubation when patients needed ventilatory support or airway protection in the prehospital setting.
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When intubating COVID-19 confirmed or suspected patients, greater experience, use of RSI, use of a PAPR, and intubation in a high vs low-income country were all associated with higher first pass success.
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In pediatric out-of-hospital cardiac arrest, patients managed by emergency physicians in a mobile ICU who had endotracheal intubation were found to have lower odds of survival at 30 days when compared to bag valve masking or supraglottic airway.
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Paratracheal pressure was non-inferior to cricoid pressure in degrading direct laryngoscopic view. Many have abandoned cricoid pressure for RSI with no ill effects, and I don’t see this replacing it.
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Use of intramuscular ketamine for patients with severe agitation resulted in significantly shorter time to sedation compared to a combination of intramuscular midazolam and haloperidol (5.8 vs 14.7 minutes).
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There was no difference between IM droperidol and IM olanzapine in time to adequate sedation for the acutely agitated ED patient. Droperidol carried a slightly higher risk of extrapyramidal effects.
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There was no short-term impact of NSAIDs/COX-2 inhibitors on long-bone fracture healing BUT using NSAIDs >3 weeks was associated with higher rates of non-union or delayed union.
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A rising ETCO2 in the setting of out-of-hospital cardiac arrest (OHCA) due to PEA has a higher chance of achieving return of spontaneous circulation (ROSC). If the change in ETCO2 is >20 mmHg during resuscitation, CPR efforts should be continued.
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If current trends stay the same, emergency medicine will likely face an oversupply of physicians in 2030. We as a specialty need to work together to find ways to mitigate this and continue doing what we do best—save lives…and livelihoods.
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A large RCT in Brazilian ICUs found no difference in 90-day mortality between patients who received balanced crystalloids versus normal saline.