OSHA releases new standard to protect front-line health workers from COVID-19
The Biden administration issued a long-awaited new workplace standard aimed at protecting front-line healthcare workers from contracting COVID-19. The emergency temporary standard, released Thursday by the Occupational... read more
What is the Ideal Approach for Emergent Pericardiocentesis Using POCUS Guidance?
A total of 166 pericardial effusions were identified during the study period. The mean skin-to-pericardial fluid distance was 5.6 cm for the subxiphoid views, which was significantly greater than that for the parasternal... read more
A Systematic Review of the Incidence and Outcomes of In-Hospital Cardiac Arrests in Patients with COVID-19
Approximately, one in 20 patients hospitalized with coronavirus disease 2019 received resuscitation for an in-hospital cardiac arrest. Hospital survival after in-hospital cardiac arrest within the ICU was higher than non-ICU... read more
Delirium and long term cognition in critically ill patients
Delirium, a form of acute brain dysfunction, is very common in the critically ill adult patient population. Although its pathophysiology is poorly understood, multiple factors associated with delirium have been identified,... read more
How I Went from Pulmonary Diagnostics and Wellness to System Lung Coordinator
Main Line Health is a multi-hospital health system serving patients in Philadelphia, PA, and its western suburbs. The system has been recognized as among the best in the region by U.S. News & World Report. In 2017, it was... read more
What the Flecainide is going on here?
A 54-year-old woman is brought to the emergency department for palpitations. In triage she has a heart rate of 120 bpm, BP 143/89, SpO2 99%. Shortly after being roomed, she begins to complain of worsening symptoms and looks... read more
Therapeutic vs. Prophylactic Anticoagulation for COVID-19 Patients with Elevated D-dimer Concentration
In patients hospitalised with COVID-19 and elevated D-dimer concentration, in-hospital therapeutic anticoagulation with rivaroxaban or enoxaparin followed by rivaroxaban to day 30 did not improve clinical outcomes and increased... read more
Health Systems Successfully Leverage Tele-ICU During Pandemic and Intend to Continue
Help during the pandemic for overwhelmed, overworked intensive care unit (ICU) nurses at some health systems came in the form of experienced tele-ICU nurses working remotely to support on-site colleagues as they cared for... read more
Lactate = LactHATE
Like many others who attended SMACC earlier this year I returned home dazed and confused about the significance of lactate in the septic patient. So like any good (aspiring to be) evidence-based medicine practitioner,... read more
Protecting The Injured RV in COVID-19 ARDS
The abnormal interaction between the right ventricle (RV) and pulmonary vasculature in various disease states is associated with adverse clinical outcomes. Impaired RV physiology in acute respiratory distress syndrome (ARDS)... read more
Non-invasive Respiratory Support and P-SILI in COVID-19
Coronavirus disease 2019 (COVID-19) pneumonia is associated with hypoxemic respiratory failure, ranging from mild to severe. Due to the worldwide shortage of intensive care unit beds, a relatively high number of patients... read more
Do team and task performance improve after training situation awareness?
This intervention study shows that a 2-h education in situation awareness improved parts of team performance in an acute care situation. Team leadership and task management improved in the intervention group, which may indicate... read more
Protocol and statistical analysis plan for the PREPARE II randomised clinical trial
Cardiovascular collapse is a common complication during tracheal intubation of critically ill adults. Whether administration of an intravenous fluid bolus prevents cardiovascular collapse during tracheal intubation remains... read more
Factors Associated With Initiation of ECPR in the Pediatric Population
Although extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly utilized in the pediatric critical care environment, our understanding regarding pediatric candidacy for ECPR remains unknown. Our objective... read more
Diagnostic accuracy of prehospital serum S100B and GFAP in patients with mild TBI
Early prehospital and in-hospital S100B levels 0.10 μg/L was 100% (95%CI: 89.1;100.0) in prehospital samples and 100% (95% CI 89.1;100.0) in in-hospital samples. The specificity was 15.4% (95%CI: 12.4;18.7) in prehospital... read more
Tocilizumab Use May Be Associated with a Short-term Mortality Benefit
For hospitalized COVID-19 patients, there is some evidence that tocilizumab use may be associated with a short-term mortality benefit, but further high-quality data are required. Its benefits may also lie in reducing the... read more
Why and How to Open ICU to Family Visits During the Pandemic
Since the lockdown because of the pandemic, family members have been prohibited from visiting their loved ones in hospital. While it is clearly complicated to implement protocols for the admission of family members, we believe... read more
Higher Level of Mobilization Improves Health Status
In critically ill survivors, achieving higher levels of mobilization, but not increasing the number of active mobilization sessions, improved health status 6 months after ICU admission. The dosage of mobilization in ICU... read more
COVID-19 Pathophysiology: Looking Beyond Acute Disease
Careful descriptions of the clinical features of acute disease in patients infected with the novel coronavirus SARS-CoV-2 had begun to emerge before WHO declared the outbreak of COVID-19 a public health emergency of international... read more
Severity of Hypoxemia may Explain Indeterminate Results in Pediatric Trials of iNO
Inhaled nitric oxide (iNO) is used for refractory hypoxemia in acute respiratory distress syndrome (ARDS) via vasodilation of pulmonary arterioles to ventilated alveoli, particularly in pediatrics. However, iNO has not affected... read more
COVID-19 ARDS has higher EVLWi and PVPI values than non-COVID-19 ARDS
Compared to acute respiratory distress syndrome (ARDS) patients without COVID-19, patients with COVID-19 had similar lung mechanics, but higher extravascular lung water index (EVLWi) and pulmonary vascular permeability index... read more
Steer Clear of Magnesium for COPD
Knowingly or not, we in emergency medicine tend to lean into the Dutch hypothesis, a 1960s postulate that asthma and COPD are part of a spectrum of common disease (chronic obstructive lung disease), and should be considered... read more
