ANDROMEDA-SHOCK - Capillary Refill vs. Lactate

ANDROMEDA-SHOCK - Capillary Refill vs. Lactate

Peripheral perfusion guided resuscitation was better than lactate clearance in patients with septic shock in regard to improving organ dysfunction at 72 hours (SOFA score) and barely missed statistical significance in reducing 28-day mortality.

Multiplex PCR in Critically Ill Hematology Patients

Multiplex PCR in Critically Ill Hematology Patients

Presence of any virus on multiplex PCR (particularly influenza, parainfluenza, and RSV) in critically ill hematology patients was associated with an increased risk for respiratory failure and ICU mortality.

Is This Patient Really Penicillin Allergic?

Is This Patient Really Penicillin Allergic?

Penicillin allergy is a lot less common than patients report. A low-risk history could allow you to prescribe it in the ED or clinic.

Pediatric Needle Decompression - What Size Needle?

Pediatric Needle Decompression - What Size Needle?

A standard 5cm 14-16 gauge needle for chest decompression was more than twice as long as needed for children < 13 years old based on CT chest wall thickness (CWT).

Succinylcholine or Rocuronium - Which Is Better?

Succinylcholine or Rocuronium - Which Is Better?

A large observational series with over 4,000 intubations compared succinylcholine vs. rocuronium in rapid sequence intubation and found no association between these two paralytics and first-pass intubation success or peri-intubation adverse effects.

PROTRACH - HFNC for Preoxygenation in the ICU

PROTRACH - HFNC for Preoxygenation in the ICU

High-flow nasal cannula (HFNC) compared to bag-valve mask (BVM) ventilation for preoxygenation of critically ill patients did not improve lowest SpO2 but significantly reduced severe complications (SpO2 < 80%, severe hypotension, and cardiac arrest); 6% HFNC vs. 16% BVM, NNT = 10.

Nerve Agent Incidents and Public Health Preparedness

Nerve Agent Incidents and Public Health Preparedness

Management of nerve agent (NA) poisoning requires recognition of the syndrome and availability of the antidote. It is important to remember that besides the classic “SLUDGE” and “Killer B’s,” there is also the nicotinic syndrome which can cloud the clinical presentation. Add the “weekdays” mnemonic for nicotinic effects to your list of symptoms in NA toxicity.

Shockingly Ineffective - Double Sequential Defibrillation for Refractory Vfib and Vtach

Shockingly Ineffective - Double Sequential Defibrillation for Refractory Vfib and Vtach

Prehospital double sequential defibrillation was not associated with improved survival for out-of-hospital cardiac arrest patients with refractory ventricular fibrillation or pulseless ventricular tachycardia.

Antiarrhythmics In Arrest - New ILCOR Update

Antiarrhythmics In Arrest - New ILCOR Update

The European Resuscitation Council International Liaison Committee on Resuscitation 2018 guideline has made one minor change regarding antiarrhythmic drugs in arrest: lidocaine, in place of amiodarone, is now a viable, equally effective option in patients with VF/pVT refractory to defibrillation.

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