What’s the Right Pediatric ETT Size?

What’s the Right Pediatric ETT Size?

The pediatric trachea is elliptical at the infraglottic level, with the transverse diameter being narrowest. The endotracheal tube size formula, (age/4) + 3.5, with a cuffed tube makes more sense anatomically.

Is IJ or Subclavian Safer Under Ultrasound Guidance?

Is IJ or Subclavian Safer Under Ultrasound Guidance?

In this randomized trial of anesthetized patients, ultrasound-guided internal jugular venous catheters had a lower arterial puncture rate, pneumothorax rate, catheter misplacement, and access time compared to ultrasound-guided subclavian venous catheterization.

Heatstroke

Heatstroke

Heatstroke is a deadly triad of hyperthermia, CNS dysfunction, and multiorgan failure. Classic (or passive) heatstroke is due to environmental exposure and poor heat dissipation, whereas exertional heatstroke is related to strenuous physical activity. Prompt recognition and treatment can be life-saving and is focused on rapid cooling.

Dual Sequential Defibrillation - Earlier Is Better?

Dual Sequential Defibrillation - Earlier Is Better?

Dual sequential defibrillation (DSD) was ineffective overall in refractory ventricular fibrillation (v-fib) in terminating v-fib to return of spontaneous circulation (ROSC). The subgroup in which DSD was performed earlier (shocks 4-8) had improved ROSC.

EcLiPSE - Should Levetiracetam Replace Phenytoin for Pediatric Status Epilepticus?

EcLiPSE - Should Levetiracetam Replace Phenytoin for Pediatric Status Epilepticus?

There was no difference in levetiracetam vs phenytoin as second-line agents after benzodiazepines for pediatric status epilepticus in median time to seizure cessation. Levetiracetam may have other advantages, as it is able to be given over 5 minutes (vs 20 minutes for phenytoin) and causes fewer adverse effects.

Door-to-Antibiotic And Mortality in Sepsis

Door-to-Antibiotic And Mortality in Sepsis

Mortality was higher when door-to-antibiotic time was > 3 h. However, there was no difference when comparing mortality in those given antibiotics within the first hour to those after the first hour.

Does Ramped Position Impact Intubation Success?

Does Ramped Position Impact Intubation Success?

There was no difference in first pass success with a non-supine (ramped) vs supine intubating position in this retrospective study, and composite adverse events were more common when ramped.  But patients most likely to be ramped were also obese or had predicted difficult airway.

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