recent articles

practice updates

Massive Blood Transfusion

"There has been ongoing controversy regarding the ratio of components that should be given during massive transfusion"

How do you avoid inducing a coagulopathy in trauma patients requiring massive blood transfusion? Zach Radwine, MD summarizes the recent evidence for the 1:1:1 ratio.

practice updates

Intubating the Critically Ill Patient

"Two independent variables associated with post-ETI arrest: Pre-induction shock index and weight"

Intubating beyond the ABCs: Learn how to support your crashing patient while providing definitive airway management. Zach Radwine, MD covers identification of patients at risk for hypotension, dealing with hemodynamic instability, and how to address the numerous complications that may arise.

practice updates

Push-Dose Pressors

"Despite the multitude of studies, the excellent results, and the commonplace use by anesthesiologists for decades, the use of push-dose pressors has not yet made its way into standard emergency medicine practice"
For a patient in shock, or with anticipated instability during procedural sedation, push-dose pressors can be a lifesaver. Brendon Browning, DO covers administration of pressors under circumstances in which central lines and infusions either aren't available or aren't needed.

Peds EM Morsels

Rapid MRI for VP Shunt Evaluation

"Patients with hydrocephalus will have nearly 4 scans per year during childhood"

For evaluation of VP shunts in children, the cost and study duration a rapid MRI is closer to CT than you might think (and without the ionizing radiation!). Best of all, the evidence comes from studies performed with populations chiefly less than 5 years of age. In this article, Sean M. Fox, MD makes a strong argument about why rapid MRIs should be a part of your institution's protocol.