It Is a Marathon, Not a Sprint – Sustainability of Stewardship in ICUs

It Is a Marathon, Not a Sprint – Sustainability of Stewardship in ICUs

ICUs are arguably the most important yet most challenging hospital environments for antimicrobial stewardship. The stakes are high with critically ill patients, where the burden of resistant Gram-negative pathogens is greater... read more

Acinetobacter Baumannii Native Valve Infective Endocarditis

Acinetobacter Baumannii Native Valve Infective Endocarditis

This report underlines the severe nature of A. baumannii infections, which are still associated with a prolonged hospital stay, and increased morbidity, mortality, and medical costs. Infective endocarditis caused by Acinetobacter... read more

Two-Step Imputation and AdaBoost-Based Classification for Early Prediction of Sepsis on Imbalanced Clinical Data

Two-Step Imputation and AdaBoost-Based Classification for Early Prediction of Sepsis on Imbalanced Clinical Data

Sepsis is a life-threatening response to infection that causes tissue damage, organ failure, and death. Effective early prediction of sepsis would improve patients’ diagnosis and reduce the cost associated with late-stage... read more

ED Evaluation and Management of Non-Obstetric Abdominal Pain in the Pregnant Patient

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

Experience Caring for a Severe COVID-19 Patient With ARDS in the ICU

Experience Caring for a Severe COVID-19 Patient With ARDS in the ICU

The author's experience caring for a patient with COVID-19 whose condition deteriorated rapidly into a critical illness in the negative pressure room of the ICU is described in this article. The onset of severe acute... read more

14-Day Occurrence of Hypoxia, ICU Admission, and Death Among Patients with COVID-19

14-Day Occurrence of Hypoxia, ICU Admission, and Death Among Patients with COVID-19

Uncertainty surrounding COVID-19 regarding rapid progression to acute respiratory distress syndrome (ARDS) and unusual clinical characteristics make discharge from a monitored setting challenging. Model derivation and... read more

Decompensated Hypothyroidism: Why do we miss it, and how do we improve?

Decompensated Hypothyroidism: Why do we miss it, and how do we improve?

A 75-year-old female is brought to the Emergency Department (ED) by emergency medical services (EMS) for altered mental status. Vital signs include BP 87/64, HR 55, T 92.6 rectal, RR 12, SpO2 95% on room air. She is oriented... read more

Panel Provides a Look at the Fast-changing Science of COVID-19 Diagnosis, Therapy, and Prevention

Panel Provides a Look at the Fast-changing Science of COVID-19 Diagnosis, Therapy, and Prevention

As the pace of research related to COVID-19 continues at an unprecedented rate, clinicians on the front line of the pandemic are challenged to keep up with a deluge of information to ensure they are bringing best practices... read more

Real-time AI prediction for major adverse cardiac events in emergency department patients with chest pain

Real-time AI prediction for major adverse cardiac events in emergency department patients with chest pain

An artificial intelligence (AI) real-time prediction model is a promising method for assisting physicians in predicting major adverse cardiac events (MACE) in ED patients with chest pain. Further studies to evaluate the impact... read more

Shedding Light on a Hidden Source of Septic Shock with POCUS

Shedding Light on a Hidden Source of Septic Shock with POCUS

Septic shock has a high mortality rate, estimated to be higher than 40% [1], increasing as time passes without appropriate treatment. Hence, correct diagnosis of the cause of sepsis is essential to provide correct antibiotic... read more

Comparison of Clinical Features of COVID-19 vs Seasonal Influenza A and B in US Children

Comparison of Clinical Features of COVID-19 vs Seasonal Influenza A and B in US Children

In this cohort study of 315 children with COVID-19 and 1402 children with seasonal influenza, there were no statistically significant differences in the rates of hospitalization, admission to the intensive care unit, and... read more

Hydroxychloroquine With or Without Azithromycin

Hydroxychloroquine With or Without Azithromycin

Among patients hospitalized with mild-to-moderate COVID-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care. A total of 667 patients... read more

Bedside ECHO To Diagnose Native Valve Infective Endocarditis

Bedside ECHO To Diagnose Native Valve Infective Endocarditis

Infective endocarditis (IE) is an important pathology to detect in the Emergency Department (ED), but the diagnosis is too often delayed or missed. IE ticks many boxes as a diagnosis we can "own" in Emergency Medicine (EM): 1.... read more

Right Heart Thrombus in Transit Diagnosed With Focused Cardiac Ultrasound

Right Heart Thrombus in Transit Diagnosed With Focused Cardiac Ultrasound

Pulmonary embolism (PE) is a potentially fatal entity that is frequently diagnosed in the emergency department (ED). Emergency physicians (EPs) routinely perform focused cardiac ultrasound (FOCUS) to support a prompt ED diagnosis... read more

High Breath-by-Breath Variability Is Associated With Extubation Failure in Children

High Breath-by-Breath Variability Is Associated With Extubation Failure in Children

High respiratory variability during spontaneous breathing trials is independently associated with extubation failure in children, with very high rates of extubation failure when these children develop postextubation upper... read more

Increase in Rare Brain Inflammation and Stroke Linked to COVID-19

Increase in Rare Brain Inflammation and Stroke Linked to COVID-19

Preliminary clinical data indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with neurological and neuropsychiatric illness. Responding to this, a weekly virtual coronavirus... read more

Biomarkers of Sepsis: Time for a Reappraisal

Biomarkers of Sepsis: Time for a Reappraisal

The precise roles of most biomarkers in the management of septic patients have not been well defined, and of the many biomarkers that have been studied, only a few have been evaluated in large or repeated studies. As... read more