Hospitalists are in the ideal position to perform bedside procedures on their patients. They know every aspect about their patients and have had the opportunity to develop a good rapport and the trust of their patients. So, why are they…
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In the emergency department (ED), colorimetric or quantitative capnography is the gold standard for confirmation of endotracheal tube placement. Capnography may be unreliable in patients with severe pulmonary obstruction, greatly reduced pulmonary circulation, or cardiac arrest. Transtracheal ultrasound imaging with…
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Traditional dogma teaches that it is crucial for trauma patients to reach the hospital and be treated within 1 hour of injury (the “golden hour”). Investigators reviewed data from a large trauma registry to determine outcomes for two cohorts of…
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Use of video laryngoscopy (VL) results in improved glottic views, fewer intubation attempts, and higher intubation success in both operating room and emergency department (ED) patients. Less is known about performance characteristics of VL during urgent inpatient intubations performed in…
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A Canadian team has performed a population-based case-control study in Ontario to determine whether this interaction might confer risk for sudden death, which can be triggered by hyperkalemia. During an 18-year period, 349 patients (age, ≥66) died suddenly while taking both…
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Differences between Traumatic LPs and SAH. How Traumatic lumbar punctures Impact Healthcare Decisions.How to Differentiate Traumatic Lumbar Punctures from Aneurysmal Subarachnoid Hemorrhage The diagnosis of subarachnoid hemorrhage (SAH) often requires lumbar puncture, however, in an estimated 10% to 30% of…
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The key points of dual antiplatelet therapy are that there is NO mortality benefit for DAPT vs ASA alone; there is a small but significant decrease in coronary stent thrombosis and major adverse cardiac events, but there is also an…
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Previous investigations suggest that survival to hospital discharge following out-of-hospital cardiac arrest (OHCA) has remained stable (7%–8%) over the past 30 years. Recent recommendations regarding bystander and rescuer cardiopulmonary resuscitation (CPR) technique, post-resuscitation protocols, and regionalization of post-arrest care were…
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Hepatic encephalopathy (HE) is one of the major complications of cirrhosis, and recent evidence suggests that hospitalized cirrhotic HE patients with acute decompensation and, especially, acute-on-chronic liver failure (ACLF) have extremely poor outcomes. The current review article discusses the pathophysiology…
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Most patients with pulmonary embolism (PE) do well, and outpatient management is becoming more common. Predicting which patients will have complications would be valuable in order to triage patients for discharge or admission to a ward or intensive care unit…
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Perioperative Hyperglycemia Predicts Postoperative Complications only in Non-Diabetics Limited research has suggested that nondiabetic surgical patients who develop perioperative hyperglycemia are at above-average risk for postoperative complications. In this retrospective study, researchers examined the relation between perioperative glucose levels and…
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What Should We Do About A-Fib/Flutter when There Is Another Acute Condition? Rapid atrial fibrillation or flutter (A-fib/flutter) can be managed by rate or rhythm control, but prior studies have focused on A-fib/flutter occurring in isolation. Now, investigators have retrospectively…
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Based on meta-analysis of randomized, controlled trials, noninvasive positive pressure ventilation (NPPV) is the only intervention that improves mortality in patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD). However, many patients who are eligible for this intervention go…
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In a review of 198 cases, the principal etiologies were viral infection and autoimmune disease; outcomes were good in about 50%. Due to its relatively low incidence, acute encephalitis remains poorly studied. To better define the etiology, clinical presentation, and…
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Radial artery catheters are frequently placed in the emergency department (ED) and intensive care unit (ICU) for hemodynamic monitoring and arterial blood gas analysis. A number of small studies have compared ultrasound-guided placement of radial artery catheters to traditional placement…
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