Blog
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Nov 03 2017
Which Compression to Ventilation Ratio Should You Use?
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.
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Nov 02 2017
Lazarus Phenomenon – Delayed ROSC After CPR Termination
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).
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Nov 01 2017
Cricoid Pressure Is Mechanically Impossible
This study found it was mechanically impossible to maintain 30-40N of downward force during the laryngoscopy phase of RSI.
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Oct 31 2017
DOAC vs Warfarin Related Non-Traumatic ICH
Compared with vitamin K antagonist (VKA)-related non-traumatic intracerebral hemorrhage (ICH), direct oral anticoagulant (DOAC)-related ICH had less disability, smaller bleeds, and the meta-analysis showed lower in-hospital mortality rates.
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Oct 30 2017
Do Pediatric CAP Patients Need a Blood Culture?
In children without other comorbidities, with moderate to severe community acquired pneumonia requiring hospitalization, the yield of blood culture was very low. Most isolated organisms were Streptococcus pneumoniae, 82% of which were penicillin sensitive.
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Oct 28 2017
SCIWORA in the NEXUS Study
Spinal cord injury without radiographic abnormality (SCIWORA) was very rare, 27/34069 (0.08%). Although NEXUS enrolled 3000 patients <18 years, down to age 1, all patients with SCIWORA were adults in this cohort.
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Oct 27 2017
Should We Give Delayed Lytics for Stroke Over Age 80?
Elderly stroke patients over age 80 who received tPA >3 - 4.5 hours from time of onset were more likely to have symptomatic intracranial hemorrhage (SICH), 10% vs 8% in the <3-hour group, but overall mortality and percentage with good neurological outcome was the same in the delayed group as patients who received it in under 3 hours.
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Oct 26 2017
Mounting Evidence for Dexamethasone in Pharyngitis
In patients age 5 years through adulthood with sore throat of any cause, use of a single, low-dose steroid (most often dexamethasone 10mg or 0.6mg/kg for children, max 10mg; most given orally) were twice as likely to have pain relief at 24 hours.
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Oct 25 2017
News Flash – Asymptomatic Trauma Patients With Negative Scans Do Well
Asymptomatic blunt trauma patients over age 14 with a negative CT abdomen/pelvis did not have delayed missed injuries.
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Oct 24 2017
Pediatric Pneumonia Exam Unreliable – CARPE DIEM Study
Substantial agreement on clinical exam findings in children with suspicion of pneumonia was only present for wheezing and retractions. All other clinical exam findings had poor to moderate agreement between clinician examiners.