Clay Smith
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Aug 23 2024
Did the Heimlich Maneuver Just Choke?
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Back blows outperformed abdominal thrusts and chest compressions in successful clearance of out-of-hospital foreign body airway obstructions (FBAO).Source
Evaluation of basic life support interventions for foreign body airway obstructions: A population-based cohort study. Resuscitation. 2024 Aug;201:110258. doi: 10.1016/j.resuscitation.2024.110258. Epub 2024 May 31. PMID: 38825222. -
Aug 22 2024
Non-Adherence – Doxycycline’s Weakness for Treatment of STI
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A single center retrospective treatment of 144 patients who tested positive for C. trachomatis found that 18% (n=26) of patients did not pick up their prescription for doxycycline. Those who did not obtain their doxycycline prescription were 3 times more likely to return to the ED within 28 days for the same chief complaint.Source
Doxycycline adherence for the management of Chlamydia trachomatis infections. Am J Emerg Med. 2024;81:136-139. doi:10.1016/j.ajem.2024.05.003. PMID: 38728936. -
Aug 21 2024
PROFUNDUS – POCUS-Plus for Aortic Syndromes
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Using the aortic dissection detection (ADD) risk score in addition to point-of-care ultrasound (POCUS) and D-dimer, providers can increase their diagnostic accuracy and ensure that the appropriate patients are receiving advanced imaging to make the diagnosis of acute aortic syndrome (AAS).Source
Diagnosis of acute aortic syndromes with ultrasound and d-dimer: the PROFUNDUS study. Eur J Intern Med. 2024 Jun 12:S0953-6205(24)00234-6. doi: 10.1016/j.ejim.2024.05.029. Epub ahead of print. PMID: 38871565. -
Aug 20 2024
CLOVERS and CKD – How Much Is Too Much Fluid?
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This secondary analysis of the CLOVERS trial demonstrated a significant reduction in 90-day mortality, more ventilator free days, and more vasopressor free days among patients with advanced CKD and sepsis-induced hypotension randomized to a restrictive fluid strategy with earlier vasopressor use compared to a more liberal fluid strategy.Source
Fluid management for sepsis-induced hypotension in patients with advanced chronic kidney disease: a secondary analysis of the CLOVERS trial. Crit Care. 2024 Jul 11;28(1):231. doi: 10.1186/s13054-024-05019-6. PMID: 38992663; PMCID: PMC11238412. -
Aug 19 2024
Best Tips for Bougie Use in Airway Management
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This comprehensive article on bougie use during emergency airway management covers all things bougie, with a lot of technical tips. We cover the highlights.Source
Managing Emergency Endotracheal Intubation Utilizing a Bougie. Ann Emerg Med. 2024 2024 Jun 22:S0196-0644(24)00232-4. DOI: 10.1016/j.annemergmed.2024.04.021. PMID: 38912998. -
Aug 16 2024
When to Pan-Scan vs. Selectively CT Elderly Patients
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Based on key history and physical examination findings, the Eastern Association for the Surgery of Trauma (EAST) developed an algorithm for the evaluation of blunt trauma patients ≥65 years.Source
Scanning the aged to minimize missed injury: An EAST multicenter study. J Trauma Acute Care Surg. 2024 May 27. doi: 10.1097/TA.0000000000004390. Online ahead of print. PMID: 38797882 -
Aug 15 2024
Should We Preemptively Start Oxygen for Pediatric Sedations?
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A large retrospective registry analysis finds no difference in rates of additional respiratory interventions with preemptive administration of supplemental oxygen during pediatric sedation.Source
Preprocedural Oxygenation and Procedural Oxygenation During Pediatric Procedural Sedation: Patterns of Use and Association With Interventions. Ann Emerg Med. Published online June 12, 2024. doi:10.1016/j.annemergmed.2024.04.014. -
Aug 14 2024
BLING III RCT – Continuous vs. Intermittent Antibiotics
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This was a large RCT of critically ill adults with suspected infection who were randomized to receive either continuous infusions or intermittent dosages of intravenous antibiotics. 90-day mortality between groups was not statistically significant, while clinical cure rate was higher in the continuous infusion group.Source
Continuous vs Intermittent β-Lactam Antibiotic Infusions in Critically Ill Patients With Sepsis: The BLING III Randomized Clinical Trial. JAMA. Published online June 12, 2024. -
Aug 13 2024
Point | Counterpoint – DL Is Not the Building Block for Learning VL
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Yesterday we looked at an argument for learning DL prior to VL. Today, we are covering the counterpoint, where this group argues that DL is not the building block for learning VL.Source
COUNTERPOINT: Direct Laryngoscopy: The Building Block to Airway Expertise? No. Chest. 2024 Jun;165(6):1297-1299. doi: 10.1016/j.chest.2024.01.027. PMID: 38852967 -
Aug 12 2024
Point | Counterpoint – DL Should Be Learned Before VL
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Today we are looking at an opinion piece published in Chest where the authors provide an argument that DL should be learned prior to VL.Source
POINT: Direct Laryngoscopy: The Building Block to Airway Expertise? Yes. Chest. 2024 Jun;165(6):1296-1297. doi: 10.1016/j.chest.2023.12.035. PMID: 38852966.