Direct vs Video Laryngoscopy In 1878 William MacEwan first passed a tube into the trachea of an awake patient using his fingers as a guide. Now health care providers routinely perform endotracheal intubation as a life saving intervention. Despite over…
Read MorePreface: Patients with COPD exacerbations requiring ICU admission did better with low-dose steroids vs high-dose steroids Cohort study of 17,239 patients with COPD exacerbations admitted to the ICU * 1/3 required noninvasive ventilation * 15% were intubated * Virtually all…
Read MoreThe USPSTF continues to recommend screening primarily in 65- to 75-year-old men who have ever smoked. U.S. Preventive Services Task Force (USPSTF) Background Prevalence of abdominal aortic aneurysms (AAAs; defined by an aortic diameter of ≥3.0 cm) in adults older…
Read MoreIn a randomized trial, absorbable sutures achieved cosmetic results and complication rates similar to those of nonabsorbable sutures in both children and adults. Absorbable sutures have been demonstrated to be safe and effective for repair of facial lacerations (NEJM JW…
Read MoreFrequently the combination of a serum D-dimer level and compression ultrasound testing can differentiate between a residual venous clot and an acute recurrent DVT. However, sometimes the results are equivocal and in these situations an MRI direct thrombus imaging can…
Read MorePatients with minimal free fluid and no abdominal tenderness can be observed, while patients with moderate-large amounts of free fluid and abdominal tenderness should undergo operative exploration. To determine if operative exploration or observation is the preferred management for hemodynamically…
Read MoreTwo systematic reviews and meta-analyses have demonstrated no long-term benefit for back pain, leg pain, or disability using epidural steroid injections for either sciatica or lumbar spinal stenosis. The first systematic review and meta-analysis in 2012 analyzed 23 trials of…
Read MoreThis is an excellent review on the diagnosis, triage, and management of both community-acquired pneumonia and healthcare-associated pneumonia (HCAP). This review also contains important information about clinical scoring tools to know which patients require admission, which patients require ICU care,…
Read MoreThis is a nice review on azithromycin to prevent chronic obstructive pulmonary disease exacerbations (COPD exacerbations). A recent Cochrane analysis and a retrospective VA study were both found that continuous azithromycin use decreased the incidence of COPD exacerbations in patients…
Read MoreThe American Association of Respiratory Care developed a clinical policy describing the benefit of continuous capnography during mechanical ventilation. This policy statement recommends continuous capnometry during mechanical ventilation for a number of reasons: 1. It confirms that the endotracheal…
Read MoreNoninvasive continuous arterial pressure monitoring using finger photoplethysmography is not quite ready for prime time. This technology is comparable to cuff pressures, but this technology is far too variable compared with invasive arterial blood pressure monitoring using an arterial line.…
Read MoreArterial lines are not completely benign. They can definitely cause catheter-related bloodstream infections. This study shows that arterial lines have a rate of bloodstream infection of about 1 in 1,000 catheter days. Femoral arterial lines have a higher rate of…
Read MoreMy second Hospital Procedures Consultants Conference took place in Denver, Colorado! I was very excited to visit Denver, as it was my first time to the city. Denver was beautiful in June. The day time weather was warm with plenty…
Read MoreFor decades we have relied on static measurements of volume status such as central venous pressure, pulmonary artery occlusion pressure and right ventricular end diastolic volume. CVP has been shown to have little better than a coin toss chance of…
Read MoreTuition Price Just Reduced for the Premier Hospitalist, Trauma, and Emergency Procedures CME course which is coming to the Millenium Knickerbocker Hotel in Chicago on July 19-20. Click Here for PDF version PRLog (Press Release) – May 15, 2014 –…
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