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Ultrasound in Cardiac Arrest

Mount Sinai EM

Initially, data suggested that the use of ultrasound during arrest increased pauses between compressions which worsens outcomes. Evidence of right heart strain is important but the evidence of fibrinolysis during arrest is mixed with many studies showing no 30-day mortality benefit to lysing during a code.

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ECG Blog #366 — Diltiazem didn't work.

Ken Grauer, MD

Figure-2: I've color-coded P waves from Figure-1 according to P wave morphology ( See text ). NOTE: For clarity — I've color-coded P waves in the long lead II rhythm strip according to morphology. These cases provide insight to assessment for MAT: The January 5, 2020 post in Dr. Smith’s ECG Blog — for an example of MAT.

EKG/ECG 195
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Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

RebelEM

There has been ongoing study about the clinical significance of these effects, as well as whether and for whom LR might provide meaningfully better clinical outcomes ( Myburgh 2013 , Self 2018 , Semler 2018 , Self 2020 ). The enrollment was multicenter, large, and adequately powered for clinically meaningful changes in outcome.

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The DIMPLES study

Don't Forget the Bubbles

What outcomes did they look at? Was the outcome accurately measured to minimise bias? The inability to test for SARS-CoV-2 antibodies may have led to an underestimation of the impact of the virus on the reported outcomes. Mintegi, S., & Country Leads (2020). Was the follow-up of subjects complete enough? Bressan, S.,

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Issue #4: The Latest in Critical Care, 6/12/23

PulmCCM

TTM2 found no improvement in survival or neurologic outcome among patients randomized to cooling to a target of 33 °C, as compared to controls receiving fever prevention (e.g. Use code PULMCCM15 and get 15% off when you register online.

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Pulse oximeters overestimate O2 saturations in darker-skin patients; FDA acts (again)

PulmCCM

According to a 2023 analysis of applications for FDA approval , as late as 2020 manufacturers were complying with a minimum of effort—e.g., Draft Guidance Document Wong et al. Clinical Outcomes Associated With Overestimation of Oxygen Saturation by Pulse Oximetry in Patients Hospitalized With COVID-19. Nature (news).

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Improving Care for Patients with a Non-English Language Preference (NELP)

EMDocs

13 Interventions may include: Ascertaining a patient’s preferred language early in the clinical encounter (during registration, for instance), and clearly documenting this preference in a place that is visible to all providers. Utilizing certified interpreters and documenting their use. Educating patients on their rights.