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Authors: 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 […]
Read MoreAuthors: Johnson NJ et al., Resuscitation 2014 Sep 6; A small registry study adds to the growing body of literature showing feasibility of ECLS. Extracorporeal life support (ECLS) has been used as a rescue strategy for patients who do not respond to standard resuscitation. Investigators report outcomes for 26 adults who received ECLS for out-of-hospital, […]
Read MoreSeveral years ago, a California study showed that a half-dozen elective surgeries were being performed far more often in Humboldt County than they were in the rest of the state. The procedures included hip and knee replacements, hysterectomies and carotid endarterectomies, a surgery to remove plaque buildup in the carotid arteries. Geographical variation in the […]
Read MoreThis is for our chronic pain providers who might order NSAIDS. Published in J Allergy Clin Immunol Pract 2014 Jul/Aug 2:414 Authors: Aun MV et al. Epinephrine is first-line treatment for drug-induced anaphylaxis, but it is underutilized. Anaphylaxis is a life-threatening hypersensitivity reaction that can be allergic or nonallergic. Allergic causes of drug-induced anaphylaxis generally […]
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 large clinical […]
Read MorePublished in Anesthesiology on 02 2015. Authors: Michael P. Eaton, M.D. et al Background: Antifibrinolytic medications such as ε-aminocaproic acid (EACA) are used in pediatric heart surgery to decrease surgical bleeding and transfusion. Dosing schemes for neonates are often based on adult regimens, or are simply empiric, in part due to the lack of neonatal pharmacokinetic information. […]
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