Targeted temperature management (TTM) still requires active cooling to 36°C and meticulous avoidance of hyperthermia. Becoming lax in this may be associated with increased mortality.
This rapid review by BMJ included ADRENAL and APROCCHSS along with 40 other RCTs and made a weak recommendation to use corticosteroids (CCS) for patients with sepsis. You’ll want to pull up the free full text with some great infographics.
Individual risk factors associated with the development of severe alcohol withdrawal syndrome (SAWS) included a history of delirium tremens and baseline BP ≥ 140mmHg but no individual symptoms or signs associated with exclusion of SAWS. Composite measures fared better, such as the Prediction of Alcohol Withdrawal Severity Scale; a score ≥ 4 had a LR of 174 (95% CI 43-696).
It is estimated that to place an endotracheal tube (ETT) successfully in 30-60 seconds, using direct laryngoscopy, would take 3-5 years of experience and 137-243 endotracheal intubations (ETI). Increased experience did not reduce the time chest compressions were paused. The key take home is that ETI during CPR is really hard. Be prepared.
In this systematic review and meta-analysis, no single aspect of the physical examination, imaging, or LRINEC score had high enough sensitivity to exclude necrotizing soft tissue infections. Contrast CT performed the best, but it was only 94.3% sensitive at best. If you have a high clinical suspicion, early surgical consultation is necessary for definitive diagnosis and management.