New GOLD Guidelines for COPD Exacerbations

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Endocrinology, Mechanical Ventilation, Medical General, Respiratory diseases
More Tags – COPD, HPC updates, mechanical ventilation, noninvasive ventilation, procalcitonin, steroids
Beta2-agonists and anticholinergics are the initial bronchodilators Prednisone 1 mg/kg/day (up to 60 mg/day) or steroid equivalent for moderate-severe exacerbations x 5-7 days Antibiotics indicated for moderate-severe exacerbations with pulmonary infiltrate or sputum purulence –procalcitonin level >0.25 ng/mL supports antibiotic…
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Intubation During In-Hospital CPR Decreases Survival and Neurological Outcomes

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Endotracheal Intubation, medical procedures
More Tags – cardiac arrest, CPR, endotracheal intubation, HPC updates
This study was an observational cohort study of adult patients who had an in-hospital cardiac arrest between 2000 through 2014.   A US-based multicenter registry of in-hospital cardiac arrest was studied and included 108,079 adult patients at 668 hospitals. Two…
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Prophylactic Corticosteroids Decrease Stridor and Reintubation in High-risk Extubations

ICU Equipment and Nurse in Mechanical Ventilation Course
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Mechanical Ventilation, medical procedures, Respiratory diseases
More Tags – extubation, HPC updates, mechanical ventilation
The overall incidence of extubation failure is about 15%, but this failure rate may be increased in patients with high risk characteristics.  Patients who have prolonged mechanical ventilation, those with high cuff pressures, poor cuff leaks, and those who have…
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Drones Deliver AEDs Faster than Ambulances in Out-of Hospital Cardiac Arrests

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Emergency Procedures, medical procedures
More Tags – automated external defibrillators, cardiac arrest, HPC updates, ventricular fibrillation, ventricular tachycardia
Out-of-hospital cardiac arrests (OHCA) have a survival rate of only 8-10%.  The most critical factors for patient survival is the early administration of good bystander CPR and early defibrillation in shockable rhythms.  Currently, defibrillators are transported to OHCA victims only…
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