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Another Study on Peripheral Vasopressors

RebelEM

Historically the administration of vasopressors was restricted to central venous catheters (CVC) due to concerns for local tissue injury resulting from vasoconstriction if extravasation occurred from a peripheral IV. Peripheral Administration of Norepinephrine: A Prospective Observational Study. Paper: Yerke JR et al. CHEST 2024.

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Grand Rounds Recap 1.31.24

Taming the SRU

Ultrasound: Make “windows of access”. For blood product administration, PROPPR showed that 1:1:1 platelet, plasma, and pRBC administration led to earlier hemostasis along with less death due to blood loss and whole blood compared to separate blood product administration led to decreased death at 24 hours.

PPE 98
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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

RebelEM

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy. Severe acute traumatic coagulopathy = PT >1.5

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Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Taming the SRU

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. Ultrasound Guided Peripheral IV (USGIV) Access anatomy of arm veins when considering USGIV. Place ultrasound machine on the opposite side of the bed to minimize neck strain.

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EM@3AM: Murine Typhus

EMDocs

The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. Food and Drug Administration. State of the art of diagnosis of rickettsial diseases: the use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus. Curr Opin Infect Dis. 2016 Oct;29(5):433-9. 2009.09.010.

EMS 101
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The Latest in Critical Care, 2/5/24 (Issue #28)

PulmCCM

Ultrasound Is Upvoted The panel weakly suggested bedside ultrasound for patients with fever and an abnormal chest radiograph, but only if an expert is available to interpret the often complex or borderline results. Ultrasound can quickly and more accurately identify significant biliary disease (e.g.,

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Midline Catheters in Paediatrics – The Long and Short of it.

Don't Forget the Bubbles

Ultrasound-guided insertion is by far the ideal method of venous catheterisation, especially in Paediatrics. Midlines are preferred over routine peripheral cannulas for IV drug administration lasting more than four days. They are not suitable for CT contrast administration. What are the methods for cannulation?