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To Treat or Not to Treat

Sensible Medicine

For many doctors in academic medicine, publishing in peer reviewed journal is an important part of their careers. People can rise through the academic ranks as gifted clinicians, creative and effective educators, and talented administrators. [i] Patients were then randomly assigned to apixaban or 81 mg of ASA. to 0.88; P=0.007).

Stroke 97
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The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults

RebelEM

They can be associated with side effects such as reflex bradycardia, decreased stroke volume in phenylephrine, tachycardia and hypertension associated with epinephrine. However, peripherally dosed push dose pressors, (PDPs), are beginning to be administered more frequently for management of acute hypotension.

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Sepsis alerts work! Just not in the patients who fire the alerts

PulmCCM

With financial penalties coming for noncompliance with the new rule, hospital administrators rapidly deployed the alerts to fire on all eligible inpatients. Administratively, CMS could convert SEP-1 to a “process”-based or “intermediate outcome measure” or another type. And have they fired.

Sepsis 45
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The PROPHY-VAP Trial: Ceftriaxone to Prevent VAP in Patients with Acute Brain Injury

RebelEM

3, 6 Among patients with stroke or traumatic brain injury (TBI), the risk may be as high as 28%-76% and 23%-60%, respectively. Limited to academic hospitals in one country, which may call generalizability into question. Post-stroke infection: a systematic review and meta-analysis. 4, 8 Paper: Dahyot-Fizelier, C., Vermeij, J.

CDC 111
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Grand Rounds Recap 2.14.24

Taming the SRU

Early recognition and prompt treatment is key. non-invasive positive pressure ventilation and IV nitroglycerin infusion have been shown to reduce morbidity (intubation rates, ICU admission) & mortality.

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TXA in head injuries

Don't Forget the Bubbles

Again, there was no increase in thrombotic stroke in the TXA group – TXA looks safe. But remember – although the academic debate is great fun, don’t let it delay neuro-protective measures while debating the evidence! in the TXA group vs 53.7% in the placebo group). This study moves trauma care beyond just ‘survival’.

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Contrast Media Shortage of 2022 – Lessons Learned

EMDocs

Relative proportions of reported diagnostic indications versus clinical outcomes in a retrospective analysis of all CT imaging in 3 EDs over 1 year at an academic center. A 12% reduction in CECTs performed was recorded after EHR interventions in a large health system encompassing 12 hospitals including academic and community medical centers.