In the second part of this two-part series, Dr. Michael Wong discusses the process for obtaining consent for incapable persons in the Emergency Department. For a review of a rational and patient-centered approach to difficult discussions in the Emergency Department around goals of care and resuscitation, please see the firstRead More →
Journal Club Summary Methodology: 3/5 Usefulness: 3.5/5 Annane D, et al. N Engl J Med. 2018 Mar 1;378(9):809-818. Editorial: A Role for Hydrocortisone Therapy in Septic Shock? Question and Methods: Large multi-center, double-blinded, randomized-controlled trial comparing effects of steroids (fludrocortisone + hydrocortisone) to placebo on 90-day mortality of ICU patientsRead More →
In this two-part series, Dr. Michael Wong begins by reviewing a rational and patient-centered approach to difficult discussions in the Emergency Department around goals of care and resuscitation. In part two, we discuss the process for obtaining consent for incapable persons in the Emergency Department. Common pitfalls with the currentRead More →
The Tactical Combat Casualty Care (TCCC) Guidelines are the standard of care for the modern battlefield. TCCC offers operational guidelines for a range of combat personnel – from recommendations for all combatants to combat paramedics and SOF medics. Though these guidelines represent years of cumulative civilian and battlefield experience andRead More →
Gallstone diseases are common and can lead to various intraabdominal emergencies. Gallstones are found in approximately 6% of men and 9% of women in the United States [1]. Epidemiological studies in Scandinavia reported even higher prevalence, finding 13-18% of men and 15-25% of women had gallstones [2]. Common risk factorsRead More →
Journal Club Summary Methodology: 3/5 Usefulness: 3.5/5 Annane D, et al. N Engl J Med. 2018 Mar 1;378(9):809-818. Editorial: A Role for Hydrocortisone Therapy in Septic Shock? Question and Methods: Large multi-center, double-blinded, randomized-controlled trial comparing effects of steroids (fludrocortisone + hydrocortisone) to placebo on 90-day mortality of ICU patientsRead More →
Point of Care Ultrasound (POCUS) is becoming increasingly prevalent in Emergency Departments (EDs) for diagnostic, procedural, and management purposes. In this post, we will examine some less known, but extremely useful, indications for POCUS. For further information, please visit our POCUS archives and see Dr. Rajiv Thavanathan’s previous Grand RoundsRead More →
Journal Club Methodology Score: 4/5 Usefulness Score: 3/5 Sprigg N, et al. Lancet. 2018 May 26;391(10135):2107-2115 Question and Methods: Multicenter, double-blinded, randomized, placebo-controlled trial comparing if IV TXA vs placebo, given within 8h of spontaneous (non-traumatic) ICH onset, decreased death or dependence at 90 days. Findings: No difference in 90dRead More →
Mechanical CPR is a technology whereby a machine performs chest compressions in place of a human provider. These devices are becoming increasingly prevalent in the prehospital and in-hospital arenas, and it is inevitable that healthcare providers will interact with them in some capacity. Given the variable evidence in the literature,Read More →
Hemorrhage is the leading cause of preventable death on the battlefield. Damage Control Resuscitation (DCR) works synergistically with Damage Control Surgery (DCS) and prioritizes non-surgical interventions that reduce morbidity and mortality due to trauma and hemorrhage. DCR aims to restore homeostasis and prevent or mitigate tissue hypoxia and coagulopathy. ThisRead More →