Mon.Mar 17, 2025

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Sedation and Analgesia Guideline Update

PulmCCM

Virtually all critically ill patients experience pain, anxiety, sleep disturbance, agitation, or a combination of these bothersome symptoms. Relieving these burdens should be considered a fundamental aspect of caring for the most seriously ill. Sedatives and analgesics can also be overused, slowing patients’ recovery or increasing their likelihood of disability.

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I have been doing this for 10 years

First 10 EM

I have been doing this for 10 years now. I am not sure what the future holds. I am not sure what First10EM will look like in another 10 years. I am not sure these words will be published (although if you are reading it, I guess we have our answer). This is an exercise […] The post I have been doing this for 10 years appeared first on First10EM.

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How a Meta-Analysis can Mislead—The Story of Complete vs Culprit-only PCI in STEMI

Sensible Medicine

When a doctor does an angiogram during an ST-elevation MI (STEMI), there is a culprit occlusion but often other partial occlusions. The question is: should the doctor stent just the culprit obstruction or all the obstructions? This is a controversial topic in cardiology—not only to sort out the best way to handle STEMI, but more so about how it informs the nature of stable CAD.

Shock 95
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Medical Music Mondays: 3 LPs and 1 DJ

PEMBlog

There are several things you can do to increase your likelihood of success when performing a lumbar puncture in children. Local anesthesia! Early stylet removal! Needle bevel to the hips! Lyrics [CHORUS] Three LPs and one DJ Spinal tap procedure learn the right way [VERSE] Yo, roll the kid side lying tight Or upright holder if that seems right! Early sty let removal, thats the trick, Steady with the hands, dont move too quick!

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Normal ACS care, everything by the book! But normal ACS care could be much better. This post explains everything.

Dr. Smith's ECG Blog

Written by Willy Frick A man in his 60s with a history of hypertension and 40 pack-year history presented to the ER with 1 day of intermittent, burning substernal chest pain radiating into both arms as well as his back and jaw. It has been stuttering, lasting 10 minutes at a time with associated diaphoresis. His ECG obtained around 8 AM is shown: ECG 1 My guess is most blog readers will make this diagnosis without too much difficulty.

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Scabies infestations

Don't Forget the Bubbles

Which first-line treatment protocol is most likely to be successful? Our most commonly used scabicides in the UK are topical Permethrin 5% cream and oral Ivermectin. This is represented in the guidance given by NICE (National Institute of Clinical Excellence) and BSPAD (British Society for Paediatric and Adolescent Dermatology). Despite multiple systematic reviews , there has long been a debate about which of these is best as the first line and in what protocol (e.g., single dose, repeated dose)

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Enhancing healthcare workforce well-being: Strategies for success

NRC Health

Healthcare employee burnout poses a significant threat, impacting both staff retention and the quality of patient care. A recent NRC Health webcast explored effective strategies to combat burnout by focusing on fostering trust, granting control, and implementing continuous listening practices within healthcare organizations. The post Enhancing healthcare workforce well-being: Strategies for success appeared first on NRC Health.

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Managing Severe Hypoxemia

Critical Care Now

Reading Time: 4 minutes ARDS is a heterogeneous disease process with a complex pathophysiology. A central component of ARDS is hypoxemia and decreased compliance of the lung. While the process that damaged the alveolar units may differ, the management is similar. The following discussion will highlight what tools we have to combat a disease that typically has an in-hospital mortality of near 40%.