Tag: diagnostics
Updates and Controversies in the Early Management of Sepsis and Septic Shock
For patients in the ED who are suspected of having sepsis, swift, effective management is vital to improving outcomes. This issue reviews the latest evidence on the diagnosis and treatment of sepsis and septic shock: ... read more
Indications and Outcomes of Extracorporeal Life Support in Trauma Patients
Data from the largest registry of critically ill trauma patients receiving extracorporeal life support (ECLS) demonstrates reasonable survival. With growing experience and improved safety profile, trauma should not be considered... read more
Time to Add a Fifth Pillar to Bedside Physical Examination
Inspection, palpation, percussion, and auscultation have been the 4 pillars of clinical bedside medicine. Although these basic methods of physical examination have served us well, traditional bedside examination, for a number... read more
Effect of Occupancy on Critically Ill Admissions
Effect of Emergency Department and ICU Occupancy on Admission Decisions and Outcomes for Critically Ill Patients. The volume of ICU admissions from the ED has increased around 50% from 2001-2009. Hospitals struggle with this... read more
Considerations in the Diagnosis of Idiopathic Pulmonary Fibrosis
The clinical practice guideline on diagnosis of idiopathic pulmonary fibrosis (IPF) by Raghu and colleagues has been helpful in addressing the complexities of radiological and pathological features in diagnosing IPF. The... read more
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
Selected Imaging Controversies in ED Trauma
Traumatic injuries are amongst the most common presentations for all emergency departments (ED). In 2010, there were over 1 million patients in Canada who visited the ED for trauma, result in an cost of almost 9 billion dollars.... read more
Sepsis Test Could Show Results In Minutes
A new rapid test for earlier diagnosis of sepsis is being developed by University of Strathclyde researchers. The device, which has been tested in a laboratory, may be capable of producing results in two-and-a-half minutes,... read more
Antifungal Treatment in the ICU
Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in critically ill patients. Almost 80% of IFIs are due to Candida spp., which are the third most common isolated microorganisms in the intensive... read more
Hoopla Aside, hs-cTnI is Not Catching Missed Mis
We have been searching for a tool to identify myocardial infarction patients who are truly safe for discharge ever since Pope, et al., found that we were discharging two percent of patients with MIs from the emergency department.... read more
Echocardiography and Lung Ultrasonography for the Assessment and Management of AHF
Echocardiography is increasingly recommended for the diagnosis and assessment of patients with severe cardiac disease, including acute heart failure (AHF). Echocardiography and LUS can assist in the rapid assessment of patients... read more
Clinical Performance of Beta-D-Glucan for the Diagnosis of Pneumocystis Pneumonia in Cancer Patients Tested with PCP PCR
Patients negative by both Beta-D glucan (BDG) and PCR were unlikely to have Pneumocystis pneumonia (PCP). In patients with a compatible clinical syndrome for PCP, higher BDG values (>200 pg/mL) were consistently associated... read more
Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine
Under the direction of Marc S. Sabatine, MD, MPH, Professor of Medicine, Harvard Medical School, Pocket Medicine provides the key information a clinician needs for the initial approach and management of the most common inpatient... read more
Hemodynamic Monitoring: Invasive and Noninvasive Clinical Application
Praised by nursing students for its straightforward language and readability, this interdisciplinary reference on bedside hemodynamic monitoring covers the technical aspects of clinical monitoring, including diagnostic and... read more
Value of variation index of inferior vena cava diameter in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation
The findings of this study suggest that the ΔIVCD performed moderately well in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation. Overall, 603 patients were included in this... read more
Diagnostic Accuracy of Chest Radiograph, and When Concomitantly Studied Lung Ultrasound, in Critically Ill Patients With Respiratory Symptoms
This meta-analysis demonstrates that chest radiograph has a low sensitivity and reasonable specificity compared with CT for detecting lung pathology in critically ill patients. The studies also investigating lung ultrasound,... read more
Common pitfalls in point-of-care ultrasound: a practical guide for emergency and critical care physicians
Point-of-care ultrasonography (POCUS) is a widely used tool in emergency and critical care settings, useful in the decision-making process as well as in interventional guidance. Following some rules in technique and interpretation,... read more
Antibiotic Decisions in the ICU: A Dragon’s Tale
Medical decision-making about antibiotic use in critically ill patients is challenging and complex. The need for antibiotic stewardship requires judicious prescription and choice of antimicrobials, as the need for effective... read more
Effects of Chlorhexidine Gluconate Oral Care on Hospital Mortality
Chlorhexidine oral care is widely used in critically and non-critically ill hospitalized patients to maintain oral health. We investigated the effect of chlorhexidine oral care on mortality in a general hospitalized population.... read more
Critical Decisions in Emergency Medicine
American College of Emergency Physicians regularly publishes Critical Decisions in Emergency Medicine to keep emergency medicine professionals up to date on relevant clinical issues. Build your clinical arsenal with Critical... read more
Reducing diagnostic errors in the ICU
Diagnostic error occurs in 5-20 percent of physician-patient encounters, with a comparable prevalence among ICU admissions and patients who die in the intensive care unit (ICU). Further, diagnostic errors comprise 9-12 percent... read more
Sophia Observation Withdrawal Symptoms-Pediatric Delirium Scale
The SOS-PD scale shows promising validity for early screening of Pediatric Delirium (PD). Further evidence should be obtained from an international multicentre study. A total of 2088 assessments were performed in 146 children... read more
