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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.

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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).

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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
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The Latest in Critical Care, 3/25/24 (Issue #35)

PulmCCM

In a well-randomized trial, equal numbers of clinically important differences in outcomes in opposite directions could average out to a null result, hiding the variability between patients. Neither PILOT nor ICU-ROX found a difference in outcomes with higher vs lower oxygenation targets in mechanical ventilated patients.

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A Brilliant Comment Makes the Study of the Week

Sensible Medicine

This is a common probably insurmountable problem with morbidities, such as hypertension, diabetes , COPD , etc. In these cases, not only is the diagnosis completely arbitrary on the part of the clinician, but the severity of the condition has an extremely strong influence on its contribution to the usually measured outcome.

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What are time-limited trials in critical care?

PulmCCM

Background I’m not sure if you’ve noticed this, but patients and families frequently disagree with their physicians about the likely outcomes from critical illness. 3 days for anoxic encephalopathy to regain pupillary responses after cardiac arrest, 4-7 days for a DNR/DNI patient to receive NIPPV for COPD exacerbation, etc.)

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