Treatment with lytics for acute PE (mostly massive or with arrest) in pregnancy out to 6 weeks postpartum was associated with 94% overall maternal survival and 88% fetal survival.  Major bleeding occurred in 17% of pregnant women and 58% of those in the postpartum period.

Sudden-onset, severe ("worst-ever"), sharp chest pain was the hallmark type A and B aortic dissection.  Ripping or tearing pain was present in only half of patients.  Classic features of aortic regurgitation murmur and pulse deficit were frequently lacking.

Early sepsis treatment with protocolized IV fluid, pressors, and transfusions vs usual care was undertaken in Zambia, and resulted in much higher mortality.  Most patients had HIV.  This is yet another strike against a form of early goal-directed therapy (EGDT) vs. usual sepsis care.

Using loss of wave capnography rather than gestalt assessment of relaxation after paralytic administration for RSI in the ED led to shorter time to intubation and increased first-pass success.

Morphine was associated with worse short-term mortality all other known variables being equal: 20% vs. 12.7%.

Ibutilide worked to chemically cardiovert rapid atrial fibrillation in just over half of cases but was associated with the feared complication, ventricular tachycardia, in 2 patients (0.6%).

We’ve all been taught to use the “sniffing position” when intubating patients in a supine position. However, when adding ramped positioning for pre-oxygenation and intubation, fidelity to the “sniffing position” degrades. A couple Australian anesthesiologists have written a letter to clarify the proper technique.

In patients with penetrating trauma, it was better to allow prehospital hypotension and hasten transport for definitive repair prior to beginning volume resuscitation than to try to normalize vital signs in the field by giving IV fluid.

According to this large systematic review, in adults a 30:2 compression to ventilation ratio was better than 15:2.  For kids, either ratio was better than compression only CPR, except under 1 year in which ventilations did not improve outcome beyond compression-only.

Delayed ROSC may occur after cessation of CPR - the so called Lazarus phenomenon.  The incidence is around 6/1000 cases and usually occurred within 3-8 minutes after CPR cessation.  All patients eventually died; 4 of 5 had PEA. It may be wise to allow 10 minutes before pronouncing death (or 4 days if the patient is actually named Lazarus).