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Using biomarkers such as procalcitonin (PCT) in the ER can help physicians assess the risk for sepsis before patients are admitted to the ICU. The Society of Critical Care Medicine recently updated its sepsis guidelines, recommending early empirical broad-spectrum antibiotics that are then adjusted or de-escalated as more information becomes available. “The early identification of sepsis […]
Read MoreAuthor: Landisch RM et al., JAMA Pediatr 2017 Jun 19; The time to appendectomy, if performed within 24 hours of presentation, was not associated with perforation or other complications. Although studies are inconclusive, many physicians feel that a delay in appendectomy may result in complications (perforation) and prolonged hospital stay. Using the Pediatric National Surgical Quality Improvement […]
Read MoreAlthough extracorporeal membrane oxygenation (ECMO) continues to grow in use for patients with fulminant cardiac or respiratory failure unresponsive to conventional treatment, the rescue therapy is still associated with significant morbidity and mortality, according to a team of University of Chicago Hospitals researchers. Their national database study described the characteristics of patients undergoing the procedure, […]
Read MoreEpidural steroid injections resulted in nearly twice the incidence of serious neurologic complications as epidural injections without steroids, according to a retrospective study, which also found soluble steroid injections to be just as safe as nonsteroid injections. Since 2012, when the FDA issued a letter of warning, “steroids have not been approved for epidural injections,” […]
Read MoreAuthors: Emma Seppala et al Harvard Busienss Review JUNE 29, 2017 More and more people are feeling tired and lonely at work. In analyzing the General Social Survey of 2016, we found that, compared with roughly 20 years ago, people are twice as likely to report that they are always exhausted. Close to 50% of people […]
Read MoreKaren B. Domino, MD, MPH Professor of Anesthesiology & Pain Medicine University of Washington, Seattle Martin J. London, MD Professor of Clinical Anesthesia University of California, San Francisco Avery Tung, MD Professor of Anesthesiology & Critical Care University of Chicago In an issue of Anesthesiology News, Robert E. Johnstone, MD, criticized anesthesia practice guidelines, citing “practice […]
Read MoreSASHA K. SHILLCUTT, MD It’s still dark out when I walk into the busy and bustling preoperative area where patients and their family members crowd into small bays. They hand over their personal belongings to the RNs and their trust to me. As I walk in, I grab my patient’s hand, smile and say, “Hello. […]
Read MoreAbout 20% of children develop persistent pain after surgery, and a new study published in The Journal of Pain showed that poorer night-time sleep quality was significantly associated with greater next-day pain intensity over 4 months after surgery. Researchers from the University of Washington and Seattle Children’s Hospital studied 66 children who had major surgery […]
Read MoreUrgent and emergent intubation is challenging enough, but what if your patient is sporting some type of tongue piercing? Does it make a difference? Do you need to do anything differently? Obviously, the jewelry may physically impede the process of intubating the patient, impairing visualization of structures or getting in the way of inserting the […]
Read MoreAuthor: Paul E.MarikMD, FCCP et al Background The global burden of sepsis is estimated as 15 to 19 million cases annually, with a mortality rate approaching 60% in low-income countries. Methods In this retrospective before-after clinical study, we compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone, and thiamine during […]
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