Predictors of failed intubations using video laryngoscopy such as failed Glidescope intubations

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Gastrointestinal diseases, Glidescope Intubation, medical procedures, Respiratory diseases
More Tags – airway management, direct laryngoscopy, endotracheal intubation, Glidescope intubation, HPC updates, intubation, video laryngoscopy
In a study conducted at two academic medical centers, records showed that of 71,570 intubations 2,004 used Glidescope for airway management. Success rates and complications were documented in these Glidescope intubations. The overall success rate for Glidescope intubations was 97%.…
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Steroids are beneficial for hospitalized patients with community-acquired pneumonia

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Mechanical Ventilation, medical procedures, Respiratory diseases
More Tags – endotracheal intubation, HPC updates, intubation, mechanical ventilation, pneumonia, respiratory failure
A recent meta-analysis and systematic review of 13 randomized, placebo-controlled trials analyzed over 2000  patients hospitalized for CAP.  The analysis examined whether the addition of systemic corticosteroids doses (20–60 mg of prednisone or steroid equivalent) to empiric antibiotics was any better than…
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Earlier Lumbar Puncture for Suspected Acute Bacterial Meningitis Leads to Better Outcomes

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Lumbar Puncture, medical procedures, Neurological diseases
More Tags – bacterial meningitis, HPC updates, lumbar puncture, meningitis
Although adult bacterial meningitis (ABM) is rare, the outcomes can be devastating. An area of controversy concerns when to perform lumbar puncture (LP). Because of the possibility of brain herniation, it has been recommended that cerebral computed tomography (CT) be…
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Antibiotic duration for intra-abdominal infections

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Emergency Procedures, Infections, medical procedures
More Tags – HPC updates, intra-abdominal infections, sepsis
In an open-label trial involving adults with complicated intra-abdominal infections at 23 centers in the U.S. and Canada, researchers have investigated whether fixed-duration antimicrobial therapy (4 days) after source control is as effective as the traditional strategy (antibiotic administration until 2 days…
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Lung ultrasound for diagnosis of pneumonia

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Emergency Procedures, Infections, medical procedures, Respiratory diseases
More Tags – HPC updates, lung ultrasound, pneumonia, sepsis
Lung ultrasound can detect pneumothorax and pulmonary edema, but limited data exist to quantify its accuracy for diagnosing pneumonia. In a prospective study, investigators compared lung ultrasound to chest computed tomography (CT) and chest x-ray among adult patients presenting with…
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Hospital-acquired Conditions are Higher with Weekend Admissions

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Endocrinology, Hospital Procedures
More Tags – Catheter-associated UTI, falls, hospital-acquired conditions, HPC updates, pressure ulcers
The U.S. Centers for Medicare and Medicaid Services regards serious preventable hospital-acquired conditions as “never events.” In this study, investigators used a nationwide U.S. hospital database to compare risks for 11 serious hospital-acquired conditions after weekend or weekday admissions. The…
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The Reasons Hospitalists Should Learn Hospital Procedures

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Central line, Chest Tube, Emergency Procedures, Endotracheal Intubation, FAST Exam, Glidescope Intubation, Hospital Procedures, King Tube, Lumbar Puncture, Medical General, medical procedures, Needle Decompression, Paracentesis, RUSH Exam, Thoracentesis, Ultrasound-Guided Peripheral IV
More Tags – emergency procedures, hospital procedures, HPC updates, medical procedures, simulation-based procedural training
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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Transtracheal Ultrasound Can Confirm Endotracheal Intubations

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Chest Tube, Emergency Procedures, Endotracheal Intubation, medical procedures
More Tags – endotracheal intubation, HPC updates, transtracheal ultrasound
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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How Important Is the “Golden Hour” After Trauma?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Hospital Procedures, medical procedures, Neurological diseases, Traumatology
More Tags – HPC updates, trauma, traumatic brain injury, traumatic shock
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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GlideScope VL Improves Success of Urgent Intubation by ICU Physicians

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Emergency Procedures, Endotracheal Intubation, Gastrointestinal diseases, Glidescope Intubation, King Tube, medical procedures, Respiratory diseases
More Tags – direct laryngoscopy, endotracheal intubation, Glidescope intubation, HPC updates, rapid sequence intubation
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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Bactrim or Septra and Spironolactone is a potentially deadly combination

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Emergency Procedures, Medical General, medical procedures
More Tags – Drug interactions, HPC updates, hyperkalemia, Sudden death
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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Lumbar puncture characteristics of traumatic LP versus subarachnoid hemorrhage

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Hematology, Lumbar Puncture, medical procedures, Traumatology
More Tags – HPC updates, lumbar puncture, subarachnoid hemorrhage, traumatic lumbar puncture
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 Benefits and Risks of Dual Antiplatelet Therapy

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Events, Hematology, Hospital Procedures, medical procedures, Neurological diseases
More Tags – Antiplatelet therapy, coronary stent, HPC updates, major adverse cardiac events, PCI, percutaneous coronary intervention
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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Survival to Hospital Discharge After Out-Of-Hospital Cardiac Arrest Is Increasing

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Emergency Procedures, medical procedures, Needle Decompression
More Tags – ACLS, cardiac arrest survival, CPR, HPC updates
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 with Acute Decompensated Cirrhosis and Acute-on- Chronic Liver Failure

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Gastrointestinal diseases, Hematology, Hospital Procedures, medical procedures
More Tags – cirrhosis, GI bleeding, hepatic encephalopathy, HPC updates
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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