European Guideline on Managing Post-traumatic Bleeding: 5th Edition

European Guideline on Managing Post-traumatic Bleeding: 5th Edition

An updated guideline on the management of significant bleeding and coagulopathy following major trauma has been released by the pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma. The document,... read more

Threshold Analysis as an Alternative to GRADE for Assessing Confidence in Guideline Recommendations Based on Network Meta-analyses

Threshold Analysis as an Alternative to GRADE for Assessing Confidence in Guideline Recommendations Based on Network Meta-analyses

Guideline development requires the synthesis of evidence on several treatments of interest, typically by using network meta-analysis (NMA). Because treatment effects may be estimated imprecisely or be based on evidence lacking... read more

Sepsis and Septic Shock – What Matters from EM Cases Course

Sepsis and Septic Shock – What Matters from EM Cases Course

In this podcast Dr. Sara Gray, intensivist and emergency physician, co-author of The CAEP Sepsis Guidelines, answers questions such as: How does one best recognize occult septic shock? How does SIRS, qSOFA and NEWS compare... read more

Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation

Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation

In patients presenting to the emergency department with recent-onset, symptomatic atrial fibrillation, a wait-and-see approach was noninferior to early cardioversion in achieving a return to sinus rhythm at 4 weeks. The presence... read more

Management of Pediatric Severe Traumatic Brain Injury

Management of Pediatric Severe Traumatic Brain Injury

This article provides an algorithm of clinical practice for the bedside practitioner based on the available evidence, treatment protocols described in the articles included in the 2019 guidelines, and consensus that reflects... read more

Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality

Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality

Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident cardiovascular disease (CVD) and all-cause mortality in a dose-response manner. 29,615 adults pooled... read more

Guidelines for the Management of Pediatric Severe Traumatic Brain Injury

Guidelines for the Management of Pediatric Severe Traumatic Brain Injury

Update of the Brain Trauma Foundation Guidelines, Third Edition. Severe Traumatic Brain Injury in Infants, Children, and Adolescents in 2019: Some Overdue Progress, Many Remaining Questions, and Exciting Ongoing Work in the... read more

Procalcitonin Reduces Antibiotic Use with No Negative Outcomes

Procalcitonin Reduces Antibiotic Use with No Negative Outcomes

The elderly patient presenting to the ED with nonspecific symptoms remains a diagnostic and therapeutic challenge. Often, these patients arrive with general complaints ranging from altered mental status to weakness, subjective... read more

New Guidelines for Hospital-acquired Pneumonia/Ventilator-associated Pneumonia

New Guidelines for Hospital-acquired Pneumonia/Ventilator-associated Pneumonia

American and European guidelines have many areas of common agreement such as limiting antibiotic duration. Both guidelines were in favor of a close clinical assessment. Neither recommended a regular use of biomarkers but... read more

Antibiotic Treatment of Hospital-acquired Pneumonia

Antibiotic Treatment of Hospital-acquired Pneumonia

Although more prospective therapy trials of Hospital-acquired Pneumonia (HAP) are needed, based on currently available data, it is possible to use an approach that provides appropriate therapy without the overuse of broad-spectrum... read more

Should We Stop Trending Lactate in Septic Shock?

Should We Stop Trending Lactate in Septic Shock?

There may be a tendency to cement guideline recommendations into our collective minds as inalienable and sacrosanct – as if carved onto stone tablets and brought down to us from the heights of Mount Sinai. Thoughtful medicine,... read more

Implementing Early Mobilization in the ICU

Implementing Early Mobilization in the ICU

The use of a quality improvement appraisal tool can help identify high quality projects when planning a similar mobility program. Even though projects were conducted in a variety of intensive care unit settings, and implementation... read more

Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients

Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients

This large pre-post implementation study of delirium-oriented measures based on the 2013 Pain, Agitation, and Delirium guidelines showed improved health professionals’ adherence to delirium guidelines and reduced brain... read more

Recommendations on the Use of Ultrasound Guidance for Adult Thoracentesis

Recommendations on the Use of Ultrasound Guidance for Adult Thoracentesis

The use of ultrasound guidance for thoracentesis has been associated with increased success rates and decreased complication rates. Ultrasound can be used to estimate the pleural fluid volume, characterize the effusion as... read more