Evaluation and Treatment of Renal and Perinephric Abscesses
A 30-year-old woman with past medical history of type 2 diabetes presents to the emergency department with 3 days of vague abdominal/back pain, with associated subjective fever, chills, nausea and vomiting. She states she... read more
Impaired peripheral mononuclear cell metabolism in patients at risk of developing sepsis
Dysregulated immune response is a key driver of disease progression in sepsis and known to be associated with impaired cellular metabolism. This association has been studied mostly in the late stage sepsis patients. Here,... read more
Nurses’ knowledge and practices of physical restraints in ICU
The mean scores of nurses' knowledge and practices were 61.5 (SD = 12.1) and 57.4 (SD = 9.7), respectively. More than half of nurses had poor knowledge of PR use and incorrect practice of implementing PR (51.5% and 60.5%,... read more
Endotracheal intubation to reduce aspiration events in acutely comatose patients
Whether intubation results in a reduction in the incidence of aspiration events and whether these are more frequent in patients with low GCS scores are not yet established. The paucity of evidence on this topic makes clinical... read more
Anaesthetists and intensive care doctors are at lower risk of COVID-19 infection compared with other medical staff
Following the first recorded death of an anaesthetist from COVID-19 in the UK in November 2020, a review of available data published in Anaesthesia (a journal of the Association of Anaesthetists) shows that unexpectedly,... read more
Smell test may help spot COVID-19 cases
A scratch-and-sniff screening tool that identifies impaired sense of smell, a common symptom of COVID-19, could help quickly pinpoint cases. Researchers from the University of Colorado in Boulder studied a smell test called... read more
Clinical characteristics of critically ill patients with COVID-19
In this study of critical patients infected by SARS-CoV-2 in a high-complexity hospital, the majority were comorbid elderly men, a large percentage required invasive mechanical ventilation, and ICU mortality was 25%. Design... read more
Development and assessment of the performance of a shared ventilatory system
Using standard clinical components, a system of shared ventilation consisting of two ventilatory limbs was assembled and connected to a single ventilator. Individual monitors for each circuit were developed using widely available... read more
ECG Pointers: Cocaine and ST Elevation
This ECG comes from a 21-year-old male with a history of cocaine abuse. When I say ‘history’, I mean that he just snorted some cocaine and now he has chest pain. He looks uncomfortable and sweaty, and keeps... read more
An Online Tool to Simulate the Effect of Pooled Testing for COVID-19
This diagnostic study describes an online tool created with actual severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus copy number data to help policy makers understand how pooled testing compares with single-sample... read more
The Feasibility of Studying Metabolites in PICU MODS
Metabolites are generated from critical biological functions and metabolism. This pediatric study reviewed plasma metabolites in patients suffering from multi-organ dysfunction syndrome (MODS) in the pediatric intensive care... read more
The voice of people living with COPD: what I learned from doing qualitative research
As a general respiratory physician, schooled in the clinical world of evidence-based medicine (EBM), I shared a common view that qualitative research was, well, flaky. Where was the science? The statistical significance?... read more
Rapid Resilience in the Emergency Department
It is the middle of a busy shift when you get the call that multiple casualties are incoming from a large fire. Your team scrambles to respond as the first victim, a 23 year old with 30% TBSA burns rolls in. He’s screaming... read more
Association Between Benzodiazepine Use With or Without Opioid Use and All-Cause Mortality in the US
This study found a significant increase in all-cause mortality associated with benzodiazepine use with or without opioid use in comparison with SSRI use. Benzodiazepine and opioid co-treatment, in particular, was associated... read more
Lung ventilation distribution in patients after traditional full sternotomy and minimally invasive thoracotomy
The aim of the study was to examine the post-operative ventilation distribution changes in cardiac surgical patients after traditional full sternotomy (FS) or minimally invasive thoracotomy (MIT). A total of 40 patients... read more
Changes in Drug List Prices and Amounts Paid by Patients and Insurers
In this cross-sectional study, we found that increases in drug wholesale list prices are associated with increases in net patient out-of-pocket costs and insurer payments. This finding suggests that, although discounts and... read more
Response to optic nerve sheath diameter guided detection of sepsis associated encephalopathy
regarding the blind method, being uninformed of the clinical diagnoses of patients is unavailing, since clues will still be found in patients' clinical manifestations. Therefore, two trained physicians in intensive ultrasound... read more
Ultrasound Probe: POCUS for Flexor Tenosynovitis
A 21 year-old female with no past medical history presented to the emergency department (ED) with ring finger pain and swelling of her right hand over the past six days. According to the patient, she initially developed a... read more
Risk factors and events in the adult ICU associated with pain as self-reported at the end of the intensive care unit stay
The short-term and long-term consequences of the most frequent painful procedures performed in the ICU are unclear. This study aimed to identify the risk factors associated with pain-related discomfort perceived by critically... read more
PEM Playbook – Pediatric Pain
Pain is multifactorial: it is comprised of physical, psychological, emotional, cultural, and contextual features. In children often the predominant feature may not be initially apparent. Although clinicians may focus on... read more
Will the asthma revolution fostered by biologics also benefit adult ICU patients?
Asthma exacerbations are inflammatory events that rarely result in full hospitalization following an ER visit. Unfortunately, certain patients require prolonged support, including occasional external lung support through... read more
ED Evaluation and Management of Non-Obstetric Abdominal Pain in the Pregnant Patient
A 27-year-old G4P2 female at 25-weeks gestation presents to the emergency department with right upper quadrant abdominal pain. The pain began yesterday and was initially a generalized discomfort that localized to the right... read more
