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 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

ICU ventilators overused among advanced-dementia patients

Mechanical ventilation may be lifesaving, but in certain patient cases it may prolong suffering without a clear benefit. JAMA Internal Medicine published a study of 635,008 hospitalizations of nursing-home patients with advanced... read more

Modes of Mechanical Ventilation Vary Between Hospitals and ICUs within a University Healthcare System

As evidence-based guidance to aid clinicians with mechanical ventilation mode selection is scant, we sought to characterize the epidemiology thereof within a university healthcare system and hypothesized that nonconforming... read more

Low Tidal Volume Ventilation in ARDS

In this "Breathe Easy Critical Perspective" podcast, Dr. Dominique Pepper interviews Dr. Allan Walkey. They discuss low tidal volume ventilation in ARDS. Dr. Walkey is the chair of the Early Career Professional Working Group... read more

Non-invasive Ventilation in the ED: Whom, When, How?

Timely use of NIV in the ED may decrease the need for invasive ventilation and its associated complications. The appropriate device, interface and patient selection are, therefore, key components of NIV success. Once the... read more

Management and Outcomes of ARDS Patients With and Without Comorbid Conditions

Half the patients with acute respiratory distress syndrome (ARDS) had major comorbidities, which were associated with severe ARDS, multiple organ dysfunction, and day‑28 mortality. These findings do not support the exclusion... read more

A Nightmare Airway with Rob Bryant

In terms of airway management, cricothyrotomy is one of the most advanced airway procedures an ED physician will perform. It is a last resort procedure when a patient is not able to be ventilated/oxygenated and/or intubated.... read more

Evaluating the Cost-Effectiveness of Proportional-Assist Ventilation Plus vs. Pressure Support Ventilation in the ICU in Two Countries

The published reductions in asynchrony and length of stay in the ICU with proportional assist ventilation (PAV ventilation by Medtronic) led to shorter time on ventilation, and reduced incidence of ventilator-associated pneumonia... read more

The Role of Speech and Language Therapy in Critical Care

The role of speech and language therapists (SLTs) in critical care can be unclear so this article sets out the scope of practice to increase awareness of the value of SLTs as part of the wider multidisciplinary team. Speech... read more

The Answer My Friend is Blowin’ in your Nose – High Flow Nasal Oxygen

High flow nasal oxygen is a novel device that actively humidifies and heats air to make flows of up to 60 liters a minutes tolerable. These incredibly high flows are important, because in order to provide 100% fiO2 to patients... read more

Early Noninvasive Ventilation and Nonroutine Transfusion for Acute Chest Syndrome in Sickle Cell Disease in Children

Early noninvasive ventilation combined with nonroutine transfusion is well tolerated in acute chest syndrome in children and may spare transfusion in some patients. Early recognition of patients still requiring transfusion... read more

Oxygen: Savior or Devil in a Green Dress?

If you ask any small child what doctors do or what happens in a hospital, you'll probably get some variation of "they make sick people better." Were you to ask the same question of one of those doctors or someone working... read more

Scavenging Circulating Mitochondrial DNA as a Potential Therapeutic Option for Multiple Organ Dysfunction in Trauma Hemorrhage

Trauma is a leading cause of death worldwide with 5.8 million deaths occurring yearly. Almost 40% of trauma deaths are due to bleeding and occur in the first few hours after injury. Of the remaining severely injured patients... read more

Limiting Sedation for Patients with ARDS

Current evidence supports the use of protocol-based, light-sedation strategies in critically ill patients with ARDS. Further research into sedation management specifically in ARDS populations is needed. Deep sedation strategies... read more

Advances in Critical Care Management of Patients Undergoing Cardiac Surgery

Cardiac surgery has been evolving to include minimally invasive, hybrid and transcatheter techniques. Increas‑ing patient age and medical complexity means that critical care management needs to adapt and evolve. Recent... read more

Mechanical Ventilation: Physiological and Clinical Applications

Known for its simple explanations and in-depth coverage of patient-ventilator management, this evidence-based text walks readers through the most fundamental and advanced concepts surrounding mechanical ventilation and guides... read more

Mechanical Ventilation: Physiological and Clinical Applications

The A1 Sedation Package: Better Care for Intubated Patients

You are called to the scene of a 56-year-old male found unresponsive in his garage workshop. Upon examining him you find him minimally responsive to painful stimulus, moaning and groaning. His family tells you he has high... read more

Fluid Bolus Over 15-20 Versus 5-10 Minutes Each in the First Hour of Resuscitation in Children With Septic Shock

Children receiving fluid boluses over 5–10 minutes each had a higher risk of intubation than those receiving boluses over 15–20 minutes each. Notwithstanding the lack of difference in risk of mortality and the possibility... read more

Comparing Effects Between Music Intervention and Aromatherapy on Anxiety of Patients Undergoing Mechanical Ventilation in the ICU

Music and aromatherapy interventions were both effective for ICU patients. The effects of music intervention were greater than that of aromatherapy; both interventions maintained the effects for at least 30 min. The Music... read more

When to Withdraw Resuscitation in the ED

When can and should we withdraw from continuing resuscitation in the Emergency Department? We are here to save lives. I would argue the Emergency Medicine is a very pure expression of a Doctor's role: we meet a patient, we... read more

One-Year Outcomes in Patients With ARDS

Poor functional recovery after invasive mechanical ventilation for acute respiratory distress syndrome is common. Helmet noninvasive ventilation may be the first intervention that mitigates the long-term complications that... read more