Safety of RSI in an Emergency Training Network

Safety of RSI in an Emergency Training Network

Implementation of an evidence-based care bundle and audit of practice has created a safe environment for trainees to learn the core critical care skill of Rapid sequence intubation (RSI). In our setting, checklist use was... read more

Subtle Presentations of Shock in the ED Setting

Subtle Presentations of Shock in the ED Setting

The patient was a 2-year-old female with a history of allergy to peanuts who was brought to the emergency department by her mother because of a complaint of allergic reaction. Twenty minutes prior to arrival, the patient... read more

Artificial Intelligence in Telemetry: What Clinicians Should Know

Artificial Intelligence in Telemetry: What Clinicians Should Know

Advances in artificial intelligence are beginning to unlock the potential of telemetry data to directly inform diagnosis and personalized treatment. We can see hints of this in considering the case above. Is a second... read more

Clinical Evaluation of a High-fidelity Upper Arm Cuff to Measure Arterial Blood Pressure during Noncardiac Surgery

Clinical Evaluation of a High-fidelity Upper Arm Cuff to Measure Arterial Blood Pressure during Noncardiac Surgery

The new high-fidelity upper arm cuff method met the current international standards in terms of accuracy and precision. It was also very accurate to track changes in blood pressure and reliably detect severe hypotension during... read more

COVID-19: A Critical Analysis of Chloroquine and Hydroxychloroquine Clinical Pharmacology

COVID-19: A Critical Analysis of Chloroquine and Hydroxychloroquine Clinical Pharmacology

Chloroquine and hydroxychloroquine have been used for over 60 years in the treatment of malaria, amoebic liver abscess, and several rheumatological conditions, but their clinical pharmacology is not well understood. COVID-19... read more

Prehospital On-scene Anesthetist Treating Severe TBI Patients is Associated with Lower Mortality and Better Neurological Outcome

Prehospital On-scene Anesthetist Treating Severe TBI Patients is Associated with Lower Mortality and Better Neurological Outcome

Patients with isolated traumatic brain injury (TBI) are likely to benefit from effective prehospital care to prevent secondary brain injury. Only a few studies have focused on the impact of advanced interventions in TBI... read more

Predicting Outcome in Patients with Moderate to Severe TBI Using Electroencephalography

Predicting Outcome in Patients with Moderate to Severe TBI Using Electroencephalography

Multifactorial Random Forest models using quantitative electroencephalography (qEEG) features, clinical data, and radiological findings have potential to predict neurological outcome in patients with moderate to severe traumatic... read more

Ethical Considerations About Artificial Intelligence for Prognostication in Intensive Care

Ethical Considerations About Artificial Intelligence for Prognostication in Intensive Care

New Artificial Intelligence (AI) and machine learning techniques have the potential to improve prognostication in intensive care. However, they require further refinement before they can be introduced into daily practice.... read more

Is Tranexamic Acid Going to CRASH the Management of TBI?

Is Tranexamic Acid Going to CRASH the Management of TBI?

In the recent CRASH-3 randomized trial, early administration of tranexamic acid (TXA) was associated with a non-significant reduction of head injury-related 28-day mortality in patients with isolated traumatic brain injury... read more

Ultrasound-based Clinical Profiles for Predicting the Risk of Intradialytic Hypotension in Critically Ill Patients on Intermittent Dialysis

Ultrasound-based Clinical Profiles for Predicting the Risk of Intradialytic Hypotension in Critically Ill Patients on Intermittent Dialysis

In critically ill patients on intermittent hemodialysis, the absence of hypervolemia as assessed by lung and vena cava ultrasound predisposes to intradialytic hypotension and suggests alternative techniques of hemodialysis... read more

Preoperative Risk and the Association between Hypotension and Postoperative AKI

Preoperative Risk and the Association between Hypotension and Postoperative AKI

Adult patients undergoing noncardiac surgery demonstrate varying associations with distinct levels of hypotension when stratified by preoperative risk factors. Specific levels of absolute hypotension, but not relative... read more

Use of Vasopressor Increases the Risk of Mortality in Traumatic Hemorrhagic Shock

Use of Vasopressor Increases the Risk of Mortality in Traumatic Hemorrhagic Shock

Use of vasopressor for traumatic hemorrhagic shock was associated with mortality after controlling for biases (trauma severity; volume of fluid resuscitation). Among 236,698 trauma patients, 3,551 were included in the... read more

Septic Shock and the Use of Norepinephrine IMCU

Septic Shock and the Use of Norepinephrine IMCU

Elderly patients with septic shock treated with norepinephrine (NE) displayed a better Intermediate Care Unit (IMCU) survival at the ward and at 30 days than previously expected. Our retrospective chart study did not... read more

Association Between Mean Arterial Pressure and AKI and a Composite of Myocardial Injury and Mortality in Postoperative Critically Ill Patients

Association Between Mean Arterial Pressure and AKI and a Composite of Myocardial Injury and Mortality in Postoperative Critically Ill Patients

Hypotension thresholds that provoke renal injury, myocardial injury, and mortality in critical care patients remain unknown. We primarily sought to determine the relationship between hypotension and a composite of myocardial... read more

Reduced Level of Arousal on Hospital Admission

Reduced Level of Arousal on Hospital Admission

Reduced level of arousal on hospital admission may be a strong predictor of in-hospital mortality. Most evidence was of low quality. Reduced level of arousal is highly specific to delirium, better formal detection of hypoactive... read more

The association between intravenous fluid resuscitation and mortality in older emergency department patients with suspected infection

The association between intravenous fluid resuscitation and mortality in older emergency department patients with suspected infection

Recent studies suggest that hypotension thresholds in current guidelines might be too low for older patients due to arterial stiffening, possibly leading to insufficient fluid resuscitation. We compared intravenous (IV) fluid... read more

Hypotensive Response to IV Acetaminophen in Pediatric Cardiac Patients

Hypotensive Response to IV Acetaminophen in Pediatric Cardiac Patients

In isolation of other medication, a hemodynamic response to IV acetaminophen has a higher prevalence in critically ill children with cardiac disease than previously thought and justifies controlled studies in the perioperative... read more