The anti-Xa anticoagulant lowers bleeding and death rates in a routine clinical care setting. In patients with non–ST-segment elevation myocardial infarction (NSTEMI), the factor Xa inhibitor fondaparinux was noninferior to enoxaparin in reducing ischemic outcomes in the OASIS-5 study. In…
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In prior randomized trials, the incidence of intracerebral hemorrhage (ICH) was significantly lower with the new oral anticoagulants (NOACs) than with warfarin (Blood 2014; 124:1968).  However, it remains unclear if clinical outcomes are similar when ICH does occur with different…
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Recent studies have determined the best technique for improving the safety of thoracentesis. The patient should be sitting as upright as possible. Then, ultrasound the posterior back and locate a catheter insertion point at least 6 cm lateral to the…
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A retrospective study compared the performance of Fluid and Catheter Treatment Trial (FACTT) Lite, FACTT Conservative, and FACTT Liberal. The prior FACTT demonstrated that conservative fluids is superior to liberal fluids for ARDS. A simplified conservative fluid protocol (FACTT Lite)…
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A collection of recent studies has helped determine the best protocol for removing chest tubes. For instance, a trial of water seal for at least six hours is recommended before discontinuation. The water seal reduces the need for another chest…
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In 2015 a meta-analysis found that when an ultrasound was used during a radial arterial catheter placement the first pass success rate improved. In the eleven trials that met inclusion criteria over 800 patients were enrolled. Compared to the palpation-guided…
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A recent meta-analysis of 13 studies that were investigating needle decompression compared data of sample size, mean chest wall thickness, and decompression success rates. The meta-analysis concluded that the needle decompression catheter should be at least 6.5 cm in length…
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Recently, a retrospective review of over 14,000 adult patients who underwent general anesthesia were assessed. A multivariable analysis was used to determine risk factors of difficult laryngeal mask airways (LMA). The following four risk factors were identified: male gender, age…
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Previous trials have investigated the use of B-type natriuretic peptide (BNP) to assess patients with dyspnea in the ED. The sentinel trial was the BNP (Breathe Not Properly) trial that evaluated nearly 800 patients presenting to the ED with complaints…
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A study was executed to decipher the best cut-off point for a positive Allen’s test. Ninety-three hands of 47 patients undergoing coronary artery bypass surgery were screened. The average age of the patients was 63.3 years. Independent observers examined these…
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Target Audience: Emergency clinicians Background: A multidisciplinary group of emergency physicians, radiologists, cardiologists, and others has developed appropriateness criteria for the use of imaging to help inform clinicians for four clinical scenarios presenting as chest pain in the ED. Key…
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Every four years the American College of Chest Physicians (ACCP) disseminates a new set of guidelines on the evaluation and management of venous thromboembolic disease (VTE). The ACCP just released its updated guidelines for the treatment of VTE and I…
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A prospective cohort single center study was conducted to analyze the risk associated with patients undergoing thoracentesis or small-bore chest tube placement while taking clopidogrel. Twenty-five patients taking clopidogrel gave consent to remain on the antiplatelet medication while undergoing thoracentesis…
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These guidelines are for physicians who care for patients with return of spontaneous circulation (ROSC) after cardiac arrest, including emergency physicians, critical care physicians, and cardiologists These guidelines update the 2010 International Liaison Committee on Resuscitation guidelines for patients with…
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Arterial line-associated bloodstream infections occur at rate of 0.9-3.4 infections per thousand catheter-days. This rate of infections is similar to the risk of central line-associated bloodstream infections (CLABSIs). The CDC guidelines for arterial line placement recommend the use of chlorhexidine…
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