Author: Dr Clemens

Uncategorized Published - 16 March, 2015    By - Dr Clemens
Insulin Needles Lessen Pain of Arterial Blood Gas Draws

Authors: Ibrahim I et al., Acad Emerg Med 2015 Mar 2; Drawing ABGs with a 29-gauge insulin needle instead of a standard needle is less painful and has fewer complications but results in slightly more hemolysis. While venous blood gas analysis has replaced arterial blood gas (ABG) analysis for many illnesses treated in the emergency […]

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Uncategorized Published - 13 March, 2015    By - Dr Clemens
Targeted Imaging Is the Best Approach for Pediatric Cervical Spine Evaluation

Authors: Hannon M et al., Ann Emerg Med 2014 Oct 15; Children with NEXUS risk factors for cervical spine injury should undergo plain radiographic imaging, and computed tomography should be reserved for those with positive radiographic findings. Investigators determined the optimal strategy for evaluating cervical spine injuries in children with blunt trauma, taking into account […]

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Uncategorized Published - 13 March, 2015    By - Dr Clemens
Transnasal High-Flow Humidified Oxygen for a Difficult Airway

Authors: Patel A and Nouraei SAR., Anaesthesia2014 Nov 10; A physiologic pharyngeal oxygen reservoir extends the safe apnea window. Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) is a technique for providing high-flow, positive-pressure, humidified oxygen via nasal cannula. When compared with traditional methods of apneic oxygenation, THRIVE has been shown to decrease the rate of rise […]

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Uncategorized Published - 12 March, 2015    By - Dr Clemens
Lactate Clearance and Outcomes After Cardiac Arrest Resuscitation

Authors: Lee DH et al., Resuscitation 2014 Nov 14; A Korean database study showed slightly higher rates of survival to hospital discharge with lactate reductions within the first hour. Rapid reductions in serum lactate levels have been associated with lower mortality in patients with sepsis and trauma, however, little is known about the effect in […]

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Uncategorized Published - 12 March, 2015    By - Dr Clemens
Ketamine Is an Effective Adjunct to Morphine for Pain, Even at Low Doses

Authors: Beaudoin FL et al., Acad Emerg Med 2014 Nov 21:1193 Patients receiving ketamine (at either 0.3 mg/kg or 0.15mg/kg) in addition to morphine reported better pain relief, but the higher ketamine dose was associated with more side effects. Although the use of ketamine as an adjunct to opioid treatment for pain has been previously […]

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Uncategorized Published - 12 March, 2015    By - Dr Clemens
Don’t Treat ARDS Patients with Statins

Authors: McAuley DF et al., N Engl J Med 2014 Sep 30; Another randomized study showed no benefit for ventilator-free days or 28-day mortality in patients with acute respiratory distress syndrome. Despite promising findings in observational studies, results of a large randomized, controlled trial recently demonstrated no benefit of statins in patients with acute respiratory […]

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Uncategorized Published - 12 March, 2015    By - Dr Clemens
How to Feed Critically Ill Patients: A Randomized Trial

This is for our providers who practice in the critical care unit. Authors: Harvey SE et al., N Engl J Med 2014 Oct 1; Patients in the intensive care unit had similar outcomes, whether they were fed enterally or parenterally. Debate is ongoing over the appropriate way to deliver early nutritional support to critically ill […]

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Uncategorized Published - 12 March, 2015    By - Dr Clemens
Both Manual and Mechanical CPR Commonly Cause Traumatic Injuries

Authors: Smekal D et al., Resuscitation 2014 Sep 29; Autopsies revealed chest-compression–related injuries, mostly rib fractures, in more than 75% of patients. To compare injuries from manual versus mechanical chest compressions, researchers in Sweden conducted a prospective multicenter study of 222 adults who had autopsies after unsuccessful cardiopulmonary resuscitation (CPR) following nontraumatic cardiac arrest. Overall, […]

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Uncategorized Published - 11 March, 2015    By - Dr Clemens
Sepsis Bundle Compliance Is Associated with Improved Survival

Authors: Levy MM et al., Crit Care Med 2014 Oct 1; An analysis of a large database shows a 25% relative mortality risk reduction in institutions with high versus low compliance with sepsis performance bundles. The Surviving Sepsis Campaign (SSC) has led to early identification and treatment of patients with sepsis. Using the SSC’s database, […]

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Uncategorized Published - 11 March, 2015    By - Dr Clemens
Patients in Cardiac Arrest Report Conscious Awareness

Authors: Parnia S et al., Resuscitation 2014 Oct 6; Nearly 40% of 140 cardiac arrest survivors claimed memories from when they were in cardiac arrest. Awareness during anesthesia has been well described, but what about during cardiac arrest? Researchers performed a 4-year multicenter observational study involving a qualitative and quantitative interview of 140 post-cardiac arrest […]

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