by Garrick Mok, Pascale King | May 7, 2020 | Critical Care, Featured, Grand Round Summaries, Infectious Disease, Resuscitation
The Surviving Sepsis Guidelines define sepsis as a “life-threatening organ dysfunction caused by a dysregulated host response to an infection”. Septic shock is further defined as sepsis with hypotension (MAP ≤65) and/or lactate ≥2.0 despite adequate fluid...
by Ariel Hendin, Lisa Fischer, Shahbaz Syed | Mar 27, 2020 | cardiac arrest, COVID-19, Featured, Infographics, Resuscitation, Slider
Hot off the press from CJEM; End-of-life care in the Emergency Department for the patient imminently dying of a highly transmissible acute respiratory infection (such as COVID-19).
by George Mastoras, Shahbaz Syed | Mar 26, 2020 | Airway, COVID-19, Infographics, Resuscitation
Guiding Principles Suspected SARS-COV-2 patients showing signs of hypoxemic respiratory failure should be intubated proactively, as early as possible. Signs may include FiO2 requirement > 50%, clinical signs of respiratory fatigue despite supplemental oxygen, or...
by Mark McKinney, Shahbaz Syed | Mar 12, 2020 | Featured, Grand Round Summaries, Resuscitation, Trauma
Here we present part two on our series on hypothermia. For more on the assessment, resuscitation, and management of the hypothermic patient, see part one. Prognostication of cardiac arrest in hypothermia Indicators of cardiac arrest before cooling (Brown 2012) Major...
by Mark McKinney, Shahbaz Syed | Mar 5, 2020 | Featured, Grand Round Summaries, Resuscitation, Trauma
Hypothermia results in slightly over one hundred deaths per year in Canada; typically as a result of primary hypothermia, frostbite and other cold exposure injuries (Toronto Public Health, 2014). In the United States, this is estimated at 1500 deaths annually...
by Shannon Fernando, Kate O'Connell | Jan 30, 2020 | 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...
by Bo Zheng, Alex Coutin | Jan 16, 2020 | Airway, cardiac arrest, Critical Care, Featured, Grand Round Summaries, Resuscitation
What is pulseless electric activity (PEA)? Pulseless electrical activity is diagnosed based on a patient having an organized, non-shockable rhythm and no palpable pulse. However, PEA is not always a cardiac arrest state. In many cases, patients with PEA have...
by Hans Rosenberg | Dec 16, 2019 | Full Article, Journal Club, Neurosurgery, Resuscitation, Trauma
Methodology Score: 3/5 Usefulness Score: 3/5 Cooper DJ, et al. JAMA. 2018;320(21):2211-2220. doi:10.1001/jama.2018.17075 Question/Methods: This study was done to determine the effectiveness of early prophylactic hypothermia compared with normothermic management of...
by Hans Rosenberg | Oct 7, 2019 | cardiac arrest, Cardiology, Journal Club, landmark, Resuscitation
Methodology Score: 4.5/5 Usefulness Score: 3.5/5 Lemkes JS, et al. N Engl J Med. 2019 Apr 11;380(15):1397-1407. Editorial: Coronary Angiography after Cardiac Arrest – The Right Timing or the Right Patients? Question and Methods: Patients with out-of-hospital...
by Daniel Beamish, Richard Hoang, Shankar Sethuraman | Jul 25, 2019 | Grand Round Summaries, Pre-Hospital, Resuscitation, Trauma
There was a significant amount of pre-hospital research published in 2018; many trials were that will no doubt inform future guidelines and change practice. This post seeks to look at some of the historical features of prehospital research and give us a road map for...