Bougie vs Stylet - The BEAM Trial

Bougie vs Stylet - The BEAM Trial

First attempt success was higher in the bougie group vs stylet group (98% vs 87% in all comers, 96% vs 82% in patients with at least one difficult airway characteristic). The median duration of the first-attempt as well as incidence of hypoxemia was similar between bougie and stylet groups.

IOTA - Oxygen, Less Is More

IOTA - Oxygen, Less Is More

For adults with varied acute illnesses, use of supplemental oxygen in patients with room air SpO2 of 94% or greater was associated with increased short and longterm mortality.

Are 3 Ports Better Than One? Triple Lumen Flow Rates

Are 3 Ports Better Than One? Triple Lumen Flow Rates

There were no statistically significant differences in pressure-bag flow rates for 1L of NS through all three ports of a standard triple-lumen catheter (TLC) compared to a 16 gauge peripheral venous catheter (PVC) or a 6Fr sheath introducer.  On gravity-flow, it was not statistically different from a 16 gauge PVC.  But 14ga PVC and 8.5Fr sheath rates were superior in both instances.

Time to Epi for Non-Shockable Rhythm Matters

Time to Epi for Non-Shockable Rhythm Matters

Earlier epinephrine administration for non-shockable rhythm was associated with better overall survival to discharge and neurologically-intact survival.  Reducing EMS time to the scene, time to IV (or IO) access, and time to drug may improve survival in this group of patients.

LR - When NOT to Use It

LR - When NOT to Use It

With all the talk of using balanced, lower chloride solutions for volume in the ED and ICU, we thought it might be a good idea to discuss the potential downsides of LR.

Fast PEA | Slow PEA - Survival Difference

Fast PEA | Slow PEA - Survival Difference

There is a difference between PEA rhythms.  Slow rates of electrical activity had the usual dismal prognosis.  But those with electrical rates >60 had survival and favorable neurological outcome comparable to VF/VT, 22% and 15% respectively.

Fix Leaks | Then Fill Bucket - Hypotensive Resuscitation

Fix Leaks | Then Fill Bucket - Hypotensive Resuscitation

Allowing penetrating or blunt trauma patients to remain temporarily hypotensive in the field vs giving volume resuscitation prior to definitive surgical repair improves mortality and seems to decrease blood loss and need for transfusion of blood products.

Dry Drowning - Stop the Myth

Dry Drowning - Stop the Myth

Children with a non-fatal drowning event who present to the ED with normal vital signs and normal SpO2 very rarely deteriorated.  The 3% (2/62) who had delayed complications did so within one hour of arrival.

Higher DBP In Arrest Impacts Survival

Higher DBP In Arrest Impacts Survival

Maintaining a diastolic blood pressure (DBP) of >/=25mm Hg in infants and >/= 30mm Hg in children over age 1 during CPR was associated with improved survival to discharge and improved neurologically intact survival.  This is possible only if a child arrests and has invasive BP monitoring in place but is a good reminder that high quality CPR in all patients drastically impacts survival.

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