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CJEM Visual Abstract – Emergency department crowding negatively influences outcomes for adults presenting with COPD

Canadian EM

In this issue, we collaborated with CJEM team to present “Emergency department crowding negatively influences outcomes for adults presenting with chronic obstructive pulmonary disease”​1​ in a visual abstract format. A majority of these patients are affected by chronic obstructive pulmonary disease (COPD).

COPD 75
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BIPAP IPAP: Higher is Better?

EM Literature of Note

In this unblinded, randomized-controlled trial, patients with acute exacerbations of COPD received traditional NIPPV with inspiratory pressures <18 cmH20 or “high-intensity” NIPPV, with airway pressures titrated up to 20-30 cmH20. This trial, the HAPPEN trial, looks at a little bit different approach. in each group.

COPD 93
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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. The ideal view depends on the patient’s comorbid conditions such as COPD, obesity, cachexia, etc. Ultrasound during cardiac arrest has quickly become standard.

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The Latest in Critical Care, 9/28/23 (Issue #15)

PulmCCM

Systemic corticosteroids (such as intravenous dexamethasone) improve outcomes in severe pneumonia due to SARS-CoV-2 infection. It makes sense that inhaled steroids might improve outcomes from less severe infections. Do inhaled steroids improve Covid pneumonia? About two thirds of patients in each arm were vaccinated.

COPD 95
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BPAP vs AVAPS for Hypercapnic Respiratory Failure in the ED

RebelEM

AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20 AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20 AVAPS: 0.07 P = 0.015 PaCO2 Excretion in 1 st Hour BPAP S/T: 4.75 AVAPS: 10.20

COPD 133
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Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

RebelEM

It can be used to distinguish between various conditions, including chronic obstructive pulmonary disease (COPD) exacerbation, acute heart failure (AHF), pleural effusion, pulmonary edema, pericardial effusion, pneumothorax, and pneumonia [2,3]. Patients : Compared standard of care to serial US plus stand care in patients with dyspnea.

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SGEM#447: Just What I Needed – Preoxygenation Prior To Intubation

The Skeptics' Guide to EM

Case: A 70-year-old man presents to the emergency department (ED) with an exacerbation of COPD. These results are promising and may influence future guidelines and clinical practices, emphasizing the importance of optimizing preoxygenation strategies to improve outcomes in critically ill patients.

COPD 91