Grand Round Summaries Archives - Page 2 of 20

Effect of Low-Dose Supplementation of Arginine Vasopressin on Need for Blood Product Transfusions in Patients With Trauma and Hemorrhagic Shock: A Randomized Clinical Trial

On: February 3, 2020

Methodology: 4/5 Usefulness: 2/5 Sims CA, et al. JAMA Surg. 2019 Aug 28. Question and Methods: Single-centre, double-blind, randomized control trial to determine whether low-dose vasopressin decreases the need for blood product transfusion in trauma patients with hemorrhagic shock. Findings: A total of 100 adult trauma patients were enrolled. VasopressinRead More →

Electrical vs Chemical Cardioversion in ED patients with Atrial Fibrillation (RAFF2)

By: Shahbaz Syed

On: January 31, 2020

In: Cardiology, Featured, Infographics, Journal Club

RAFF2 Ian Stiell and colleagues are back at it with atrial fibrillation; The RAFF2 trial (Electrical versus Chemical cardioversion for Emergency Department patients with Atrial Fibrillation (RAFF2); A partial factorial randomized trial) was published in The Lancet this week. Acute atrial fibrillation is an irregular dysrhythmia that should be treatedRead More →

Emerging Updates in Septic Shock

By: Shannon Fernando

On: January 30, 2020

In: All Posts, Critical Care, Grand Round Summaries, Resuscitation

In September 2018, Dr. Bram Rochwerg and I wrote a blog post on the treatment of patients with sepsis and septic shock. Much of this was based on the 2016 Surviving Sepsis Campaign (SSc) Clinical Practice Guidelines [1]. However, in a little over a year, significant new research has alreadyRead More →

Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial

By: Hans Rosenberg

On: January 27, 2020

In: Full Article, Journal Club, Neurology, Pediatrics

Methodology: 4/5 Usefulness: 4/5 Lyttle MD, et al. Lancet. 2019 May 25;393(10186):2125-2134. Question and Methods: Eclipse was an open label RCT that evaluated time to seizure cessation in pediatric SE between Keppra and Dilantin Findings: They found that Keppra was not superior (HR 1.2, 95%CI 0.91-1.60, p= 0.20) to DilantinRead More →

20 things you can do imperfectly well for Climate Change

By: Graham Wilson

On: January 25, 2020

In: Featured, Physician Wellness

And on the 6th day Graham bellowed; “let thee environment be considered among thy seven dimensions of wellness.” And so, the environment was added to the wheel of physical, social, spiritual, occupational, intellectual, financial and emotional wellness. Although I have to confess, compared to the authors of this week’s blogs;Read More →

A Healthier Future: Innovations for Sustainable Change

By: Edward Xie

On: January 24, 2020

In: Featured, Physician Wellness

On a sweltering night in July, I’m called to see a patient with difficulty breathing. I work in Toronto, where past estimates have placed the number of heat-related deaths at about 120 each year. With Canada heating twice as fast as the world average, that number is likely rising. InRead More →

System Change is Needed to Combat Climate Change

By: Courtney Howard

On: January 23, 2020

In: Featured, Physician Wellness

Increasing awareness of the urgency of climate change, led by the youth climate movement, and growing felt impacts of the health effects of climate change, including the devastating bushfires in Australia, are fuelling a global increase in interest in the concepts of “eco-anxiety” and “ecological grief.” How to cope withRead More →

What can Emergency Physicians do for Planet Wellness?

By: Curtis Lavoie

On: January 22, 2020

In: Featured, Physician Wellness

As a species, we’re making bad choices – polluting the planet and making life difficult now, and perhaps impossible in the future. As physicians, it is time to do what you do best: heal the planet. Ok sure, that sounds corny, but take a listen and let me explain howRead More →

I may die from old age, but my children may die from climate change…

By: Gary Bota

On: January 21, 2020

In: Featured, Physician Wellness

I’m a boomer Canadian Emergency physician, with a special interest in climate change. My oral fellowship exam took place in a small hotel room where facial bone x-rays were held up against the Montreal skyline awaiting my interpretation. I went directly from resident to ED director of what would ultimatelyRead More →

Danger, Climate Emergency Ahead

By: Joe Vipond

On: January 20, 2020

In: Featured, Physician Wellness

I’ll admit it, I’m scared. Every day, my newsfeed is filled with more news stories and scientific papers underlining the fact that our society’s current trajectory is akin to suicide as a species. As someone who has grown accustomed to civilization, even grown to love it, I fear for theRead More →

Grand Round Summaries (Page 2)