The Benefit of Lung-Protective Ventilation in the ED

The Benefit of Lung-Protective Ventilation in the ED

Intubation and mechanical ventilation are commonly performed ED interventions and although patients optimally go to an ICU level of care afterwards, many of them remain in the ED for prolonged periods of time. It is widely... read more

The Shocked Intubation: Definitive Airway Sans Hypotension

The Shocked Intubation: Definitive Airway Sans Hypotension

Not many aspects of Emergency Medicine define our specialty better than resuscitation, and few concepts exemplify resuscitation better than shock and intubation. Yet few words together strike greater fear in the minds of... read more

A Familiar Story: Delirium in the Acute Care Setting

A Familiar Story: Delirium in the Acute Care Setting

A few years ago, I received report that a patient was ready to be weaned from the ventilator. He had no respiratory need for mechanical ventilation, and every time the medical team attempted to wean sedation to extubate,... read more

Bedside Ultrasound Assessment of Lung Reaeration in Patients With Blunt Thoracic Injury Receiving High-Flow Nasal Cannula Oxygen Therapy

Bedside Ultrasound Assessment of Lung Reaeration in Patients With Blunt Thoracic Injury Receiving High-Flow Nasal Cannula Oxygen Therapy

High-flow nasal cannula oxygen therapy may be considered as an initial respiratory therapy for trauma patients with blunt chest injury. High-flow nasal cannula therapy could improve lung aeration as noted by the transthoracic... read more

Critical Care Medicine: The Essentials and More

Critical Care Medicine: The Essentials and More

With a full-color design and concise, easy-to-read chapters, Critical Care Medicine: The Essentials and a Bit More covers the core elements of critical care, with a unique focus on the pathophysiology underlying clinical... read more

Effect of Bag-Mask Ventilation vs Endotracheal Intubation During CPR on Neurological Outcome After OHCA

Effect of Bag-Mask Ventilation vs Endotracheal Intubation During CPR on Neurological Outcome After OHCA

Among patients with out-of-hospital cardiorespiratory arrest (OHCA), the use of BMV compared with ETI failed to demonstrate noninferiority or inferiority for survival with favorable 28-day neurological function, an inconclusive... read more

Impact of Drug and Equipment Preparation on Pre-hospital Emergency Anesthesia Procedural Time, Error Rate and Cognitive Load

Impact of Drug and Equipment Preparation on Pre-hospital Emergency Anesthesia Procedural Time, Error Rate and Cognitive Load

Pre-preparation of Preparation on Pre-hospital Emergency (PHEA) equipment and drugs resulted in safer performance of PHEA and has the potential to reduce on-scene time by up to a third. In total 23 experiments were completed,... read more

A retrospective observational study of acquired subglottic stenosis using low-pressure, high-volume cuffed endotracheal tubes

A retrospective observational study of acquired subglottic stenosis using low-pressure, high-volume cuffed endotracheal tubes

The safety of cuffed endotracheal tubes in the neonatal and critically ill pediatric population continues to be questioned due to the theoretical risk of acquired subglottic stenosis. The incidence of acquired subglottic... read more

Alfred ICU Intubation Checklist

Alfred ICU Intubation Checklist

Here is the Alfred ICU intubation checklist. We invite you to take it and adopt it whole, or, even better, to modify it to your own department's needs. We have spent considerable time and thought developing it, as well as... read more

Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia

Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia

This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the noninferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in... read more

Should Pediatric Intensive Care Be Centralized? Trent vs. Victoria

Should Pediatric Intensive Care Be Centralized? Trent vs. Victoria

The mortality rate is lower among children admitted to specialist pediatric intensive care units (ICUs) than among those admitted to mixed adult and pediatric units in non-tertiary hospitals. In the UK, however, few children... read more

ECMO for Severe ARDS

ECMO for Severe ARDS

Mr. Jackson is a 36-year-old man whom you are caring for in the intensive care unit (ICU). Before this hospitalization, he was healthy and took no medications. He has never smoked, and he drinks three or four beers every... read more

Acute Salicylate Toxicity, Mechanical Ventilation, and Hemodialysis

Acute Salicylate Toxicity, Mechanical Ventilation, and Hemodialysis

In patients requiring intubation from acute salicylate toxicity, hemodialysis should be considered as part of management, as this is associated with decreased mortality. Salicylates are common substances that can be purchased... read more

Oxygenate, Ventilate, Do No Harm

Oxygenate, Ventilate, Do No Harm

Emergency physicians (EPs) are experts in emergent airway management and thus must be confident managing mechanical ventilation. Hospital-wide bed shortages mean that EPs will be managing admitted patients for longer periods... read more

Critical Hemoglobin Desaturation Will Occur before Return to an Unparalyzed State following 1 mg/kg Intravenous Succinylcholine

Critical Hemoglobin Desaturation Will Occur before Return to an Unparalyzed State following 1 mg/kg Intravenous Succinylcholine

The American Society of Anesthesiologists (ASA) difficult airway algorithm recommends that if initial attempts at tracheal intubation after the induction of general anesthesia are unsuccessful, the practitioner should "consider... read more

Thai cave rescue: The drug that allowed boys to survive rescue mission

Thai cave rescue: The drug that allowed boys to survive rescue mission

Thai schoolboys were rescued from the cave using dissociative ketamine plus positive-pressure facemask ventilation (to prevent water from leaking into their masks), so they basically used delayed sequence intubation strategy.... read more

Noninvasive Ventilation in Patients With ARF and Do-Not-Intubate and Comfort-Measures-Only Orders

Noninvasive Ventilation in Patients With ARF and Do-Not-Intubate and Comfort-Measures-Only Orders

A large proportion of patients with do-not-intubate orders who received noninvasive ventilation survived to hospital discharge and at 1 year, with limited data showing no decrease in quality of life in survivors. Provision... read more