Rapid Resilience in the Emergency Department

Rapid Resilience in the Emergency Department

It is the middle of a busy shift when you get the call that multiple casualties are incoming from a large fire. Your team scrambles to respond as the first victim, a 23 year old with 30% TBSA burns rolls in. He’s screaming... read more

Association Between Benzodiazepine Use With or Without Opioid Use and All-Cause Mortality in the US

Association Between Benzodiazepine Use With or Without Opioid Use and All-Cause Mortality in the US

This study found a significant increase in all-cause mortality associated with benzodiazepine use with or without opioid use in comparison with SSRI use. Benzodiazepine and opioid co-treatment, in particular, was associated... read more

Substituting Acetaminophen for Fentanyl Feasible in PCI for STEMI

Substituting Acetaminophen for Fentanyl Feasible in PCI for STEMI

In patients with STEMI given crushed ticagrelor before PCI, using IV acetaminophen instead of IV fentanyl as a painkiller did not increase pain levels or platelet reactivity and prevented delay of ticagrelor's effects, researchers... read more

Perioperative Care of Patients with Fragility Fractures During the COVID-19 Pandemic

Perioperative Care of Patients with Fragility Fractures During the COVID-19 Pandemic

High quality prompt care of all people with hip and other fragility fractures is a key component of helping with patient outcomes and bed occupancy during the coronavirus pandemic. Anaesthetists have a key role in ensuring... read more

Methylnaltrexone for Treatment of Opioid-induced Constipation in Critically Ill Patients

Methylnaltrexone for Treatment of Opioid-induced Constipation in Critically Ill Patients

No evidence to support the addition of methylnaltrexone to regular laxatives for the treatment of opioid-induced constipation in critically ill patients; however, the confidence interval was wide and a clinically important... read more

A Prospective Observational Study of High-Dose Intrathecal Diamorphine in Laparoscopic Bariatric Surgery

A Prospective Observational Study of High-Dose Intrathecal Diamorphine in Laparoscopic Bariatric Surgery

We have demonstrated that neuraxial blockade is a simple, practical, and feasible technique to adopt. Our case series demonstrated a high level of patient acceptability. 50 patients were included. 11 patients (22%) had... read more

Depth of Anesthesia in Children Undergoing Cardiac Surgery Under Extracorporeal Circulation

Depth of Anesthesia in Children Undergoing Cardiac Surgery Under Extracorporeal Circulation

In children undergoing cardiac surgery in our department, the use of sevoflurane-balanced anesthesia during cardiopulmonary bypass showed no superiority of inhalational agents over total intravenous anesthesia with opioids... read more

Critical Care Opioids Impact in the 21st Century

Critical Care Opioids Impact in the 21st Century

Critical Care is impacted by opioids in multiple ways. Not only do they form the backbone of managing pain and sedation in the intensive care unit (ICU), the burgeoning opioid epidemic also feeds into opioid-related ICU admissions.... read more

No Reason to Choose Tramadol over Morphine

No Reason to Choose Tramadol over Morphine

Tramadol is an opioid, but it does not bind directly to opioid receptors (or it binds so weakly that it might as well not bind at all). Its opioid action is the result of the metabolite O-desmethyltramadol, which means... read more

The Hospitalist Role in Treating Opioid Use Disorder

The Hospitalist Role in Treating Opioid Use Disorder

Opioid use disorder, like many of the other conditions we see, is a chronic relapsing remitting medical disease and a risk factor for premature mortality. When a patient with diabetes is admitted with cellulitis, we might... read more

Evaluation of a Safer Opioid Prescribing Protocol (SOPP) for Patients Being Discharged From a Trauma Service

Evaluation of a Safer Opioid Prescribing Protocol (SOPP) for Patients Being Discharged From a Trauma Service

The aims of this study were to evaluate the effects on opioid medication prescribing, patient opioid safety education, and prescribing of naloxone following implementation of a Safer Opioid Prescribing Protocol (SOPP) as... read more

Opioid-Induced Respiratory Depression Risk Prediction Tool

Opioid-Induced Respiratory Depression Risk Prediction Tool

Ludwig H. Lin, MD, and Ashish K. Khanna, MD, FCCP, FCCM, discuss Dr. Khanna's top-rated abstract, Derivation and Validation of a Novel Opioid-Induced Respiratory Depression Risk Prediction Tool, from the Society of Critical... read more

Did I Start the Opioid Epidemic?

Did I Start the Opioid Epidemic?

Prescription opioid abuse is at epidemic levels. Opioids diverted from friends and family members who have legitimate prescriptions are a major source of abused prescription opioids. Nurses are vital to any effort to combat... read more

Health Canada Eyes Opioid Restrictions for Popular Painkiller

Health Canada Eyes Opioid Restrictions for Popular Painkiller

Health Canada has launched a review of the increasingly popular pharmaceutical drug tramadol – a move that could prompt the department to reverse its controversial, decade-old decision not to classify the medication as... read more

Opioid use to worse outcomes in C. difficile

Opioid use to worse outcomes in C. difficile

A study presented at the World Congress of Gastroenterology found that patients being prescribed opioids who also have Clostridium difficile infections (CDIs) have higher peak white blood cell counts, higher creatinine elevations,... read more

Increased ICU Costs for Opioid Overdoses

Increased ICU Costs for Opioid Overdoses

ICU costs for treating opioid overdose patients increased 58% in a seven-year span, and annual deaths almost doubled, according to a study that included 162 academic hospitals. ICU admissions increased 34% over the study... read more

Prescribed Morphine Milligram Equivalents of Opioids by County

Prescribed Morphine Milligram Equivalents of Opioids by County

Despite reductions in opioid prescribing in some parts of the USA, the amount of opioids prescribed remains high relative to 1999 levels and varies substantially at the county-level. Given associations between opioid prescribing,... read more