New AHA Bradycardia Guidelines

New AHA Bradycardia Guidelines

The newest AHA guidelines address the evaluation and management of bradycardia and conduction disorders. This includes sinus node dysfunction, AV blocks, and bundle branch blocks.  Here’s what you need to know as an emergency physician.

Steroids in Sepsis - ADRENAL and APROCCHSS Included in New Review

Steroids in Sepsis - ADRENAL and APROCCHSS Included in New Review

This rapid review by BMJ included ADRENAL and APROCCHSS along with 40 other RCTs and made a weak recommendation to use corticosteroids (CCS) for patients with sepsis. You’ll want to pull up the free full text with some great infographics.

Inhaled Tranexamic Acid for Hemoptysis?

Inhaled Tranexamic Acid for Hemoptysis?

For patients with hemoptysis, inhaled tranexamic acid was associated with significantly reduced expectorated blood volume, hospital length of stay, need for invasive interventions, and hemoptysis recurrence rate at one year.

Vancomycin/Piperacillin-Tazobactam and AKI

Vancomycin/Piperacillin-Tazobactam and AKI

The combination of vancomycin plus piperacillin-tazobactam (VPT) was associated with increased risk of acute kidney injury (AKI) compared to either drug as monotherapy or other vancomycin - β-lactam combinations, NNH = 11.

Predicting Severe Alcohol Withdrawal

Predicting Severe Alcohol Withdrawal

Individual risk factors associated with the development of severe alcohol withdrawal syndrome (SAWS) included a history of delirium tremens and baseline BP ≥ 140mmHg but no individual symptoms or signs associated with exclusion of SAWS. Composite measures fared better, such as the Prediction of Alcohol Withdrawal Severity Scale; a score ≥ 4 had a LR of 174 (95% CI 43-696).

Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage

Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage

The table below summarizes the recommendations for adult patients on anti-thrombotic agents with intracranial hemorrhage (both spontaneous and traumatic). This will be focused on ED management.

How Many Intubations Does It Take For Proficiency?

How Many Intubations Does It Take For Proficiency?

It is estimated that to place an endotracheal tube (ETT) successfully in 30-60 seconds, using direct laryngoscopy, would take 3-5 years of experience and 137-243 endotracheal intubations (ETI). Increased experience did not reduce the time chest compressions were paused. The key take home is that ETI during CPR is really hard. Be prepared.

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