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Critical Care

Effect of Bag-Mask Ventilation vs Endotracheal Intubation During Cardiopulmonary Resuscitation on Neurological Outcome After Out-of-Hospital Cardiorespiratory Arrest: A Randomized Clinical Trial

2019-02-11
By: Hans Rosenberg
On: February 11, 2019
In: Airway, cardiac arrest, Critical Care, Featured, Full Article, Journal Club, Pre-Hospital

Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Jabre P, et al. JAMA. 2018 Feb 27;319(8):779-787. Question and Methods: This was a multicenter randomized trial comparing bag valve mask ventilation with endotracheal intubation performed by emergency physicians in 2043 patients with out-of-hospital cardiac arrest in France and Belgium Findings: Their primary outcome ofRead More →

Does Point-of-Care Ultrasonography Improve Clinical Outcomes in Emergency Department Patients With Undifferentiated Hypotension? An International Randomized Controlled Trial From the SHoC-ED Investigators

2019-01-07
By: Hans Rosenberg
On: January 7, 2019
In: cardiac arrest, Cardiology, Critical Care, Journal Club, Resuscitation, Ultrasound

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Atkinson PR, et al. Ann Emerg Med. 2018 Oct;72(4):478-489 Question and Methods: This was the first multicenter, prospective, RCT examining the effect of POCUS on 30-day survival of undifferentiated hypotensive patients presenting to ED. Findings: There was no important survival benefit with theRead More →

Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis

2018-11-12
By: Hans Rosenberg
On: November 12, 2018
In: Critical Care, Endocrinology, Journal Club

Journal Club Summary Methodology: 4/5 Usefulness: 4/5 Kuppermann N, et al. N Engl J Med. 2018 Jun 14;378(24):2275-2287. Editorial: Fluid Composition, Infusion Rate, and Brain Injury in Diabetic Ketoacidosis. Question and Methods: 13 centre RCT with four arms to determine the impact of fluid resuscitation rate and type on development ofRead More →

Epinephrine

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest.

2018-10-29
By: Hans Rosenberg
On: October 29, 2018
In: cardiac arrest, Cardiology, Critical Care, Journal Club, Resuscitation

Journal Club Summary: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest Methodology Score: 4/5 Usefulness Score: 3.5/5 Perkins GD, et al N Engl J Med. 2018 Jul 18. Editorial:  Testing Epinephrine for Out-of-Hospital Cardiac Arrest. Callaway CW, et al. N Engl J Med. 2018 Jul 18. Question and Methods: Multicenter, randomized,Read More →

fluids

Fill ‘er up: Fluid Responsiveness in the ED

2018-10-25
By: Ariel Hendin
On: October 25, 2018
In: Critical Care, Grand Round Summaries, Resuscitation

When we are caring for a septic patient in the ED, we know that aggressive care with early antibiotics and ensuring adequate preload saves lives. But what do we do when we aren’t sure if more fluid will help any longer? How can we finesse our fluid management in theRead More →

All in one: Sepsis in the Emergency Department

2018-09-13
By: Shannon Fernando
On: September 13, 2018
In: Critical Care, Featured

Comprehensively discussing sepsis in the Emergency Department (ED) in a three-page blog is quite frankly, impossible. You would be hard-pressed to find a disease process that has undergone such dramatic change over the past two decades. Through it all, we still do not have a complete grasp of what sepsisRead More →

From the ICU with love: 5 suggestions to help with care of the critically ill patient in the ED

2018-09-12
By: Hans Rosenberg
On: September 12, 2018
In: Critical Care, Featured

As we were preparing for our “Critical Care Week” here at the EM Ottawa Blog, I was thinking I should definitely tap into the knowledge of an ICU physician whom I know very well. That physician is also my awesome wife, Dr. Erin Rosenberg. She’s been a staff intensivist atRead More →

Fibrinolysis in Acute Pulmonary Embolism

2018-09-11
By: Michael Hickey
On: September 11, 2018
In: Critical Care, Featured

Systemic fibrinolysis (SF) in acute pulmonary embolism (PE) remains a hot topic in acute care medicine. This post will examine the available literature regarding the use of SF in different subtypes of PE. Before examining the literature, we first must review the relevant nomenclature. Defining PE The American Heart AssociationRead More →

5 Tips to Improve your Resuscitation Skills

2018-09-10
By: EMottawa
On: September 10, 2018
In: Critical Care, Featured

To open up Critical Care week, resuscitation and trauma expert Dr. George Mastoras provides us with some tips to improve your (and your team’s) resuscitation and crisis resource management skills. 1. Make teamwork everyone’s business ‘Team orientation’ is associated with higher team performance, especially among Flash teams, like those involved inRead More →

Stylet

Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation: A Randomized Clinical Trial

2018-07-16
By: Hans Rosenberg
On: July 16, 2018
In: Airway, Anesthesiology, Critical Care, Journal Club

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3/5 Driver BE, et al. JAMA. 2018 May 16. doi: 10.1001/jama.2018.6496. Question/Methods: This single-centre, randomized clinical trial enrolled 757 patients to compare first-attempt intubation success facilitated by the bougie to ETT plus stylet, in an ED where use of the bougie wasRead More →

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