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Authors: Wadia S et al., Ann Emerg Med 2014 Oct 64:385 In a study of 60 children undergoing procedural sedation with ketamine, intraocular pressure increased only by a median of 3 mm Hg. Investigators evaluated ketamine’s effect on intraocular pressure in a prospective observational study of children aged 8–18 years undergoing procedural sedation at a […]
Read MoreThe percentage of patients reporting moderate to extreme pain two weeks after surgery has plummeted in the last decade thanks to better understanding of how different classes of pain medications work, a new survey found. Overall patient satisfaction with post-op pain meds has increased slightly, from 83 percent in 2003 to 87 percent this year, […]
Read MoreAuthors: Donzé JD et al., BMJ 2014 Sep 8; 349:g5334 Risk increases with severity of sepsis. Coronary artery disease is a risk factor for postoperative arterial thrombosis; male sex, older age, cancer history, and prior venous thrombosis are risk factors for postoperative venous thrombosis. However, whether systemic inflammation (which induces a hypercoagulable state) promotes risk […]
Read MoreAuthors: Gu WJ., Chest 2014 Sep 25; A meta-analysis finds no evidence of harm. Etomidate causes laboratory abnormalities, specifically, suppression of cortisol production. Prior authors have attempted to demonstrate corresponding patient harm (NEJM JW Emerg Med Jan 16 2014). A new meta-analysis of two randomized, controlled trials and 16 observational studies involving 5552 patients helps […]
Read MoreAuthors: Stiell IG et al., Circulation 2014 Sep 24; A large prehospital study found that survival was highest when chest compression depths were between 4.0 and 5.5 cm. In 2010, the American Heart Association (AHA) suggested an increase in the target depth of chest compressions to at least 5 cm. However, there have been no […]
Read MoreAuthors: Simms ER et al., J Am Coll Surg 2014 Aug 219:181 For trauma patients who present with severe hemorrhage, using a FFP:PRBC ratio ≥0.7 during resuscitation may be beneficial. Research has shown that using higher ratios of fresh frozen plasma (FFP) and platelets to packed red blood cells (PRBCs) in the resuscitation of exsanguinating […]
Read MoreAuthors: Holst LB et al., N Engl J Med 2014 Oct 9; 371:1381 Transfusion thresholds of 7 g/dL or 9 g/dL yielded similar outcomes. Patients with septic shock are treated with early antibiotics, rapid fluid resuscitation, vasopressor/inotrope support, and blood transfusions. The Surviving Sepsis guidelines’recommendation for a transfusion hemoglobin target of 7 to 9 g/dL […]
Read MoreThis is important for our chronic pain providers to be aware of this problem. Authors: Mazer-Amirshahi M et al., Am J Emerg Med 2014 Sep 32:1068 Nationwide, opioids were administered at 35% of ED visits for headache in 2010. Treatment of primary headache disorders (migraine, tension headache) with opioids is not recommended and is more […]
Read MoreAuthors: Gallagher RA et al., Acad Emerg Med 2014 Sep 21:981 Ultrasound guidance resulted in a higher success rate, with similar rates of complications. Ultrasound-guided central line placement has shown mixed results in the pediatric population. These investigators retrospectively evaluated success and complication rates of central line placement by pediatric emergency physicians with and without […]
Read MoreThis is important because we all take care of trauma patients. Authors: Shafi S et al., J Am Coll Surg 2014 Aug 219:189 In this study of five trauma centers, compliance with clinical practice guidelines varied widely, and increased compliance was associated with reduced risk for death. To determine if there is an association between […]
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