Tag: guidelines
Angiotensin II For Septic Shock Treatment
Angiotensin II has been studied for many years and has consistently shown to increase MAP. This medication adds a new mechanism of action to the vasopressor arsenal that is already used for septic shock. Angiotensin II should... read more
Initial Arterial pH as a Predictor of Neurologic Outcome After Out-of-hospital Cardiac Arrest
Lower pH after out-of-hospital cardiac arrest (OHCA) has been associated with worsening neurologic outcome, with ... read more
AACN Procedure Manual for High Acuity, Progressive, and Critical Care
The AACN Procedure Manual for High Acuity, Progressive, and Critical Care, 7th Edition, authored by the American Association of Critical-Care Nurses, is the authoritative reference to procedures performed in high acuity,... read more
Contemporary Management of Cardiogenic Shock
Cardiogenic shock (CS) is a multifactorial and hemodynamically diverse high-acuity illness that is frequently associated with multisystem organ failure. The complexity of CS requires a widespread application of best-care... read more
Does De-escalation of Anti-MRSA Therapy for Culture-negative Pneumonia Affect Patient Outcomes?
Nosocomial pneumonia is a common hospital-acquired infection and has a high mortality rate in the critically ill. Because drug-resistant bacteria like Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus... read more
Optimizing Beta-Lactam Treatment in the ICU
The French Society of Pharmacology and Therapeutics (SFPT) and the French Society of Anesthesia and Intensive Care Medicine (SFAR) have released guidelines on the optimization of beta-lactam treatment in intensive care unit... read more
Antibiotics for Sepsis – Finding the Equilibrium
Sepsis is medicine’s last remaining preserve for unrestrained antibiotic prescribing. The Surviving Sepsis Campaign guidelines recommend empirical broad-spectrum therapy within one hour of triage for both sepsis and septic... read more
European Guideline on Managing Post-traumatic Bleeding: 5th Edition
An updated guideline on the management of significant bleeding and coagulopathy following major trauma has been released by the pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma. The document,... read more
Threshold Analysis as an Alternative to GRADE for Assessing Confidence in Guideline Recommendations Based on Network Meta-analyses
Guideline development requires the synthesis of evidence on several treatments of interest, typically by using network meta-analysis (NMA). Because treatment effects may be estimated imprecisely or be based on evidence lacking... read more
Sepsis and Septic Shock – What Matters from EM Cases Course
In this podcast Dr. Sara Gray, intensivist and emergency physician, co-author of The CAEP Sepsis Guidelines, answers questions such as: How does one best recognize occult septic shock? How does SIRS, qSOFA and NEWS compare... read more
Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation
In patients presenting to the emergency department with recent-onset, symptomatic atrial fibrillation, a wait-and-see approach was noninferior to early cardioversion in achieving a return to sinus rhythm at 4 weeks. The presence... read more
Management of Pediatric Severe Traumatic Brain Injury
This article provides an algorithm of clinical practice for the bedside practitioner based on the available evidence, treatment protocols described in the articles included in the 2019 guidelines, and consensus that reflects... read more
Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality
Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident cardiovascular disease (CVD) and all-cause mortality in a dose-response manner. 29,615 adults pooled... read more
Guidelines for the Management of Pediatric Severe Traumatic Brain Injury
Update of the Brain Trauma Foundation Guidelines, Third Edition. Severe Traumatic Brain Injury in Infants, Children, and Adolescents in 2019: Some Overdue Progress, Many Remaining Questions, and Exciting Ongoing Work in 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
New Guidelines for Hospital-acquired Pneumonia/Ventilator-associated Pneumonia
American and European guidelines have many areas of common agreement such as limiting antibiotic duration. Both guidelines were in favor of a close clinical assessment. Neither recommended a regular use of biomarkers but... read more
Antibiotic Treatment of Hospital-acquired Pneumonia
Although more prospective therapy trials of Hospital-acquired Pneumonia (HAP) are needed, based on currently available data, it is possible to use an approach that provides appropriate therapy without the overuse of broad-spectrum... read more
Should We Stop Trending Lactate in Septic Shock?
There may be a tendency to cement guideline recommendations into our collective minds as inalienable and sacrosanct – as if carved onto stone tablets and brought down to us from the heights of Mount Sinai. Thoughtful medicine,... read more
Implementing Early Mobilization in the ICU
The use of a quality improvement appraisal tool can help identify high quality projects when planning a similar mobility program. Even though projects were conducted in a variety of intensive care unit settings, and implementation... read more
Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients
This large pre-post implementation study of delirium-oriented measures based on the 2013 Pain, Agitation, and Delirium guidelines showed improved health professionals’ adherence to delirium guidelines and reduced brain... read more
Recommendations on the Use of Ultrasound Guidance for Adult Thoracentesis
The use of ultrasound guidance for thoracentesis has been associated with increased success rates and decreased complication rates. Ultrasound can be used to estimate the pleural fluid volume, characterize the effusion as... 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
