TEG for Hypocoagulable Patients with Non-Traumatic Bleeding

TEG for Hypocoagulable Patients with Non-Traumatic Bleeding

Thromboelastogram (TEG) has been extensively studied in trauma and surgical patients, but has not been well studied in nontraumatic bleeding, nor has its use been well evaluated in the emergency department. This study... read more

Gastrointestinal Complications in Critically Ill Patients With and Without COVID-19

Gastrointestinal Complications in Critically Ill Patients With and Without COVID-19

This study found a higher rate of gastrointestinal complications, including mesenteric ischemia, in critically ill patients with COVID-19 compared with propensity score–matched patients without COVID-19, suggesting a distinct... read more

Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding

Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding

In patients with high risk upper GI bleeding, who were treated with pre-endoscopy PPI and were not in persistent shock, an endoscopy performed at a median of 10 hours vs. a median of 25 hours post presentation did not reduce... read more

Critical Care and Hospitalist Medicine Made Ridiculously Simple

Critical Care and Hospitalist Medicine Made Ridiculously Simple

A fundamental and thorough guide to the treatment of hospitalized patients in critical care situations, "Critical Care and Hospitalist Medicine Made Ridiculously Simple" provides both introductory information as well as a... read more

Enteral Fluid Resuscitation? The WHO to the rescue in the ED/ICU?

Enteral Fluid Resuscitation? The WHO to the rescue in the ED/ICU?

Prior to the 1970's, restricting oral intake was a "cornerstone" therapy of diarrheal illness, due to the pervasive belief that the GI tract needed time to heal and recover before resuming normal function. This was felt... read more

Tranexamic Acid in TBI – CRASH-3 Trial Treatment

Tranexamic Acid in TBI – CRASH-3 Trial Treatment

The CRASH-3 trial is a multi-centre, randomised, placebo-controlled trial of the effects of tranexamic acid on death and disability in patients with traumatic brain injury (TBI). Patients with reactive pupils and/or mild... read more

Low-flow Assessment of Current ECMO/ECCO2R Rotary Blood Pumps and the Potential Effect on Hemocompatibility

Low-flow Assessment of Current ECMO/ECCO2R Rotary Blood Pumps and the Potential Effect on Hemocompatibility

The role of blood pumps in contributing to adverse effects at the lower blood flow rates used during ECCO2R is shown here to be significant. Current rotary blood pumps should be used with caution if operated at blood... read more

Epidemiology of Clinically Relevant Bleeding in Critically Ill Adolescents

Epidemiology of Clinically Relevant Bleeding in Critically Ill Adolescents

Clinically Relevant Bleeding (CRB) is common in critically ill adolescents who are at high risk of venous thromboembolism (VTE). Admission after trauma or surgery can be used to stratify the risk of CRB in this population.... read more

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation

The CABANA Randomized Clinical Trial. In this randomized clinical trial involving 2204 patients with atrial fibrillation, catheter ablation, compared with medical therapy, did not significantly reduce the primary composite... read more

Stress Ulcer Prophylaxis with Proton Pump Inhibitors or Histamin-2 Receptor Antagonists in Adult Intensive Care Patients

Stress Ulcer Prophylaxis with Proton Pump Inhibitors or Histamin-2 Receptor Antagonists in Adult Intensive Care Patients

In this updated systematic review, we were able to refute a relative change of 20% of mortality. The occurrence of GI bleeding was reduced, but we lack firm evidence for a reduction in clinically important GI bleeding. The... read more

Resuscitation of Endotheliopathy and Bleeding in Thoracic Aortic Dissections

Resuscitation of Endotheliopathy and Bleeding in Thoracic Aortic Dissections

In this randomized, clinical pilot trial of patients undergoing emergency surgery for thoracic aorta dissections, we found that OctaplasLG reduced glycocalyx and endothelial injury, reduced bleeding, transfusions, use of... read more

Why Do Bleeding Trauma Patients Die?

Why Do Bleeding Trauma Patients Die?

It is important that we recognize that we have seen a reduction in the number of deaths from trauma. That's a great thing of course, but we should not be complacent. It's also worth looking at where and how patients die.... read more

What’s the Bleeding Problem with Trauma Laparotomies?!

Mortality for hypotensive trauma patients undergoing emergency laparotomy have not changed in 20 years. This blog explores the literature and the future! Wait! We're emergency physicians, why do we care about laparotomies?!... read more

Transient Systolic Anterior Motion with Junctional Rhythm After Mitral Valve Repair in the ICU

Transient Systolic Anterior Motion with Junctional Rhythm After Mitral Valve Repair in the ICU

This case report shows that junctional rhythm can cause deterioration of SAM, LVOTO, and MR, and can lead to unstable hemodynamics in a patient with right ventricular failure after MVR. Atrial pacing can resolve SAM, LVOTO,... read more

EHR-guided Strategy Reduces Postop VTE Events

EHR-guided Strategy Reduces Postop VTE Events

By incorporating algorithms into the electronic health record (EHR), UPMC was able to realize a "dramatic" 72% reduction in missed doses, from 4,331 missed doses in 2014 to 1,193 in 2015, Dr. Neal told attendees in a session... read more

Airway Management Techniques during Massive Regurgitation, Emesis, or Bleeding

Airway Management Techniques during Massive Regurgitation, Emesis, or Bleeding

Friend to the show, Jim DuCanto has been obsessed with SALAD. Not the leafy greens delicately touched with a tart emulsion, but with Suction Assisted Laryngoscopy and Airway Decontamination (SALAD). Jim DuCanto, MD is an... read more

Management of the Traumatized Airway

Management of the Traumatized Airway

There is a lack of evidence-based approach regarding the best practice for airway management in patients with a traumatized airway. Airway trauma may not be readily apparent, and its evaluation requires a high level of suspicion... read more