Month: March 2019

Patient Blood Management Recs Revamped .

A group endorsed restrictive thresholds for blood transfusion but ignored some key aspects of patient blood management (PBM) in a new expert consensus statement, some said. Among the clinical recommendations suggested at the International Consensus Conference held in Frankfurt/Main, Germany in April 2018 and now published in the March 12 issue of JAMA are calls for the […]

Military Doctors In Crosshairs Of A Budget Battle

Kaiser Health News The U.S. military is devising major reductions in its medical corps, unnerving the system’s advocates who fear the cuts will hobble the armed forces’ ability to adequately care for health problems of military personnel at home and abroad. The move inside the military coincides with efforts by the Trump administration to privatize […]

Propofol infusion syndrome: a structured literature review and analysis of published case reports

Local Anesthetic Dosing

Author: The Cardiac Anesthesiologist General recommendations for average volumes of local anesthetic for specific blocks are found in Table 1. In all cases one must never exceed  the  recommended toxic limits of local anesthetic (Table 2), which should be calculated in advance and must also take into account any addition local anesthetic dose administered to the patient […]

With lawsuits looming, OxyContin maker considers bankruptcy

By GEOFF MULVIHILL and MATTHEW PERRONE The company that has made billions selling the prescription painkiller OxyContin said Wednesday that it is considering legal options including bankruptcy, a move that could upend hundreds of lawsuits claiming it had a major role in causing the U.S. opioid drug crisis. “As the company has stated, it is […]

Order of Drug Administration During Rapid Sequence Intubation with Etomidate May Not Matter

Authors: Driver BE et al. Acad Emerg Med 2019 Mar 4 This secondary analysis of emergency department RSI found no association between drug order and apnea time but is not generalizable to sedatives other than etomidate. During rapid sequence intubation (RSI), a paralytic and a sedative agent are successively administered to facilitate laryngoscopy with minimal apneic […]

The trends to know about pain management in ASCs: 4 Qs with Dr. Eric Grahling

Written by Rachel Popa Eric Grahling, MD, is founder and medical director of Plainville, Conn.-based Comprehensive Pain Management, and president of the Connecticut Pain Society. Recently, Dr. Grahling penned an op-ed on responsible pain management published in Connecticut Medicine, the peer-reviewed journal of the Connecticut State Medical Society. Here, he shares his thoughts on pain management […]

The 293 hospitals with 5 stars from CMS

We showed the bad last week so we need to show the outstanding hospitals per CMS. CMS updated its Overall Hospital Quality Star Ratings recognizing 293 hospitals with five stars. CMS’ Hospital Compare website reports on quality measures for more than 4,500 hospitals nationwide. Here is a breakdown of the updated star ratings: One star: […]

Long-term Impact of Crystalloid versus Colloid Solutions on Renal Function and Disability-free Survival after Major Abdominal Surgery

Authors: Alexandre Joosten, M.D. et al Anesthesiology 2 2019, Vol.130, 227-236. What We Already Know about This Topic: Balanced hydroxyethyl starch solution, as part of intraoperative goal-directed fluid therapy, is associated with better short-term outcomes than administration of a balanced crystalloid solution in patients having major open abdominal surgery The safety of modern hydroxyethyl starch solutions […]

Pediatric Central Line–associated Acute Deep Vein Thrombosis

Authors: T. Wesley Templeton, M.D. et al Anesthesiology 4 2019, Vol.130, 617. Central venous access in pediatric patients, although necessary in some critically ill patients and patients undergoing cardiac or other major surgical procedures, can be associated with acute and/or chronic deep venous thrombosis.1  While acute deep venous thromboses are rare in children, they can lead to […]