Semi-upright vs Supine Position for Emergency Intubations

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Emergency Procedures, Endotracheal Intubation, medical procedures, Respiratory diseases
More Tags – emergent intubation, endotracheal intubation, HPC updates, intubation, rapid sequence intubation
Prior studies have suggested that patients should be intubated emergently in an upright, head-forward position rather than in the traditional supine position.  This is especially true for intubations of morbidly obese patients where it is known that pre-oxygenation and intubation in…
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Antimicrobial Stewardship Recommends Shorter Duration of Antibiotics for Community-Acquired Pneumonia and Healthcare-Associated Pneumonia

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Emergency Procedures, Infections, medical procedures, Respiratory diseases
More Tags – antibiotic stewardship, antimicrobial stewardship, CAP, community-acquired pneumonia, HCAP, healthcare-associate pneumonia, HPC updates, pneumonia
The Infectious Diseases Society of America (IDSA) guidelines remain the gold standard guidelines for infectious disease problems.  The IDSA recommends treating patients with community-acquired pneumonia (CAP) for 5 days and it recommends treating those with healthcare-associated pneumonia (HCAP) for 7-8…
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Continuous Infusion of Beta-Lactam Antibiotics is Superior to Intermittent Dosing for Sepsis

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Hospital Procedures, Infections, medical procedures
More Tags – antibiotics, beta-lactam antibiotics, HPC updates, sepsis, septic shock
The bactericidal activity of antibiotics depends on the class of antibiotic used. Some antibiotics like vancomycin, aminoglycosides and fluoroquinolones are dose-dependent for their bactericidal activity. Other antibiotics like beta-lactam antibiotics are time-dependent antibiotics.  Time-dependent antibiotics have increased bactericidal activity the…
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Think PE in Elderly Patients Hospitalized for Syncope

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Hospital Procedures, Medical General, medical procedures, Respiratory diseases
More Tags – CT pulmonary angiogram, D-dimer, HPC updates, pulmonary embolism, syncope, ventilation-perfusion lung scan
Although pulmonary embolism (PE) occasionally presents with syncope, patients with syncope are infrequently assessed for PE. This prospective study from Italy studied 560 elderly adults (mean age, 76) who were hospitalized for syncope. Those excluded from the study included patients…
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