Clay Smith
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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. -
Aug 09 2024
TNK Up to 24 Hours for Stroke?
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In patients with large vessel occlusions(LVO) presenting 4.5-24 hours after onset, without access to endovascular thrombectomy (ET), tenecteplase(TNK) administration bested standard medical treatment(SMT) in 90-day disability-free recovery.Source
Tenecteplase for Ischemic Stroke at 4.5 to 24 Hours without Thrombectomy. N Engl J Med. 2024 Jun 14. doi: 10.1056/NEJMoa2402980. Epub ahead of print. PMID: 38884324. -
Aug 08 2024
Should We SWITCH to Craniectomy For ICH?
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The SWITCH trial found that decompressive craniectomy plus best medical treatment may improve outcomes in patients with severe intracerebral hemorrhage involving the basal ganglia or thalamus.Source
Decompressive craniectomy plus best medical treatment versus best medical treatment alone for spontaneous severe deep supratentorial intracerebral haemorrhage: a randomised controlled clinical trial. Lancet. 2024 Jun 1;403(10442):2395-2404. doi: 10.1016/S0140-6736(24)00702-5. Epub 2024 May 15. PMID: 38761811. -
Aug 07 2024
Does Liberal Transfusion Benefit Patients with TBI?
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In ICU patients with traumatic brain injury (TBI) and anemia, transfusing blood to a liberal hemoglobin threshold (10 g/dL) compared to a restrictive threshold (7 g/dL) did not lead to better neurological outcomes at 6 months.Source
Liberal or Restrictive Transfusion Strategy in Patients with Traumatic Brain Injury. N Engl J Med. 2024 Jun 13. doi: 10.1056/NEJMoa2404360. Epub ahead of print. PMID 38869931. -
Aug 06 2024
How to Spot Posterior TIA Presenting with Dizziness
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Diagnosing patients with a posterior circulation TIA who are experiencing isolated episodic dizziness can be challenging, especially when considering the difficulty in assessing individual symptoms and the small absolute number of these patients. The authors lay out a pragmatic approach for assessment and diagnosis, but the data to support a reliable clinical decision-making tool is weak.Source
Recognizing Posterior Circulation Transient Ischemic Attacks Presenting as Episodic Isolated Dizziness. Ann Emerg Med. 2024 May 23:S0196-0644(24)00214-2. doi: 10.1016/j.annemergmed.2024.04.006. Epub ahead of print. PMID: 38795083.