February 2023

New RCT – Remifentanil vs. Neuromuscular Blockers for RSI First-Pass Success

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This randomized, non-inferiority trial found that remifentanil plus hypnotics were inferior to neuromuscular blocking agents plus hypnotics for rapid sequence intubation of patients at risk of aspiration in the operating room setting.

Source
Effect of Remifentanil vs Neuromuscular Blockers During Rapid Sequence Intubation on Successful Intubation Without Major Complications Among Patients at Risk of Aspiration: A Randomized Clinical Trial. JAMA. 2023 Jan 3;329(1):28-38. doi: 10.1001/jama.2022.23550.

Watch Out for Candida auris – Traveling Incognito in Healthcare Settings

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Candida auris is an emerging, serious, multi-drug resistant fungal pathogen that can quickly spread in hospitals and long-term care facilities. Consider this in recently hospitalized patients or nursing home residents with a history of C. auris infection or colonization, as they may require appropriate infection control measures, testing, and treatment.

Source
On the Rise, Candida auris Outwits Treatments and Travels Incognito in Health Care Settings. JAMA. 2023 Jan 17;329(3):197-199. doi: 10.1001/jama.2022.17760.

I’m Still STANDING – Can this New Algorithm Distinguish Peripheral vs Central Vertigo?

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After a training session, both interns and senior emergency providers (EPs) could accurately distinguish between central and peripheral vertigo using the 4-step STANDING algorithm.

Source
Effectiveness and reliability of the 4-step STANDING algorithm performed by emergency interns and seniors for predicting central causes of vertigo. Acad Emerg Med. 2023 Jan 11. doi: 10.1111/acem.14659. Online ahead of print.

PARIS-2 RCT – Does High Flow Oxygen Help Hypoxic Children?

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As compared with standard oxygen therapy, high flow oxygen was associated with increased length of hospital stay in pediatric patients with hypoxemic respiratory failure.

Source
Effect of Early High-Flow Nasal Oxygen vs Standard Oxygen Therapy on Length of Hospital Stay in Hospitalized Children With Acute Hypoxemic Respiratory Failure: The PARIS-2 Randomized Clinical Trial. JAMA. 2023;329(3):224-234.

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