Month: November 2022

How to Get Pediatric ETT First-Pass Success – VL For the Win!

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Previously, first-attempt success rates for pediatric intubations hovered around 50%. Video-assisted laryngoscopy significantly increased first-attempt success rates and also had fewer adverse outcomes.

Source
Video-Assisted Laryngoscopy for Pediatric Tracheal Intubation in the Emergency Department: A Multicenter Study of Clinical Outcomes. Ann Emerg Med. 2022 Oct 15:S0196-0644(22)00604-7. doi: 10.1016/j.annemergmed.2022.08.021. Epub ahead of print.

Concise Review of Lytics and Endovascular Therapy for ‘Wake Up’ Stroke


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In patients presenting with ‘wake-up’ strokes, endovascular therapy improves functional outcomes, while intravenous alteplase may also provide a small beneficial impact.

Source
What is the Efficacy and Safety of Intravenous Thrombolysis and Thrombectomy Among Patients With a Wake-Up Stroke?. Ann Emerg Med. 2022;80(2):165-167. doi:10.1016/j.annemergmed.2022.02.013

Fatal Drownings: A Public Health Problem?

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Drowning is a common cause of death worldwide. The duration of submersion is the best predictor of outcome, with immediate on-scene CPR and ventilation improving outcomes. Prevention is the best medicine, with public health intervention and policy being the most effective way to prevent drowning.

Source
Prevention of and Emergency Response to Drowning. NEJM 2022 Oct 6. Doi:10.1056/NEJMra2202392

A Dark Side of Dexmedetomidine? Another Look at SPICE-III

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An increasing propofol dose, combined with a fixed dexmedetomidine infusion, was associated with decreased 90-day mortality in patients ≤ 65 years. An increasing dexmedetomidine dose, combined with a relatively fixed propofol dose, was associated with increased mortality in patients ≤65. Both associations were absent in patients > 65 years old.

Source
Dexmedetomidine and Propofol Sedation in Critically Ill Patients and Dose Associated 90-day Mortality: A Secondary Cohort Analysis of a Randomized Controlled Trial (SPICE-III). Am J Respir Crit Care Med. 2022 Oct 10. doi: 10.1164/rccm.202206-1208OC. Online ahead of print.

New ACEP Policy on Acute Heart Failure

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ACEP released acute heart failure syndrome (AHFS) consensus recommendations that cover: diagnosis with lung ultrasound, risk stratification, high-dose nitroglycerin, and early diuretics.

Source
Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Heart Failure Syndromes: Approved by ACEP Board of Directors, June 23, 2022. Ann Emerg Med. 2022 Oct;80(4):e31-e59. doi: 10.1016/j.annemergmed.2022.05.027.

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