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In: Cardiology, Cardiothoracic Surgery, Journal Club

Methodology Score: 3/5 Usefulness Score: 3/5 Nazerian P, et al. Circulation. 2018 Jan 16;137(3):250-258.  Editorial – Biomarker-Assisted Diagnosis of Acute Aortic Dissection. Question: The ADvISED trial was an International Multicenter prospective observational study of  a novel diagnostic strategy that integrated the Aortic Dissection Detection Risk Score (ADD-RS) and D-Dimer in an ED population to rule outRead More →

information

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In: Grand Round Summaries, Social Media

There is no denying that the evolution of technology will continue to alter our practice of Emergency Medicine; a prime example of this has come with the transition to electronic health information within our clinical environments. In seeking to better understand the effect of such a shift, this post aimsRead More →

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In: Critical Care, Endocrinology, Journal Club, Resuscitation

Methodology Score: 4/5 Usefulness Score: 3/5 Venkatesh B, et al. N Engl J Med. 2018 Jan 19. Journal Club Bottom Line Question/Methods: This was a international, pragmatic, double-blind, randomized, controlled trial comparing hydrocortisone as continuous infusion to placebo in patients with septic shock on  mechanical ventilation and at least 4-hoursRead More →

tracheostomy

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In: Airway, Critical Care, Featured, Grand Round Summaries

In this post, we will review the anatomy, essential history, and common presentations of tracheostomy patients in the ED, including obstruction, decannulation, bleeding, tracheal stenosis, and infection. Anatomy of a tracheostomy tube Outer cannula Sits directly in the tracheal stoma Proximal end designed to allow tube to be easily securedRead More →

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In: Featured, Journal Club, Neurology

Methodology: 3.5/5 Usefulness: 4/5 Albers GW, et al. N Engl J Med. 2018 Jan 24. Journal Club Bottom Line Question/Methods: This was a multicentre, prospective, randomized, open label, blinded outcome trial comparing thrombectomy + medical therapy vs medical therapy alone in patients with delayed presentation (6-16 hours) of proximal MCARead More →

Urgent Care

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In: Featured, Grand Round Summaries

Urgent care presents a specific set of challenging clinical questions for the emergency physician. Often, seemingly mundane presentations will leave us questioning whether or not we have managed a case appropriately. Our decision-making can be highly influenced by the long lasting effects of dogma, clinical anecdotes, or historical studies ofRead More →

intubation

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In: Anesthesiology, Featured, Grand Round Summaries, Resuscitation

In this post, we will discuss the use of neuromuscular blocking agents (NMBAs) for intubation in the Emergency Department; we will focus on considerations in predicted difficult airways (RSI vs. awake intubation), Rocuronium vs. Succinylcholine, and the indications for Sugammadex. This post will not cover laryngoscopy; although this was previouslyRead More →