"We should only intervene under very specific circumstances"Asymptomatic hypertension in the ED: Should we be screening for end-organ damage? Should we intervene? Joshua Bucher, MD covers the 2013 ACEP Clinical Policy addressing these common questions.
"The bolus insulin group had longer lengths of stay and a 6-fold increase in hypoglycemic episodes"Anand Swaminathan, MD MPH (@EMSwami) addresses urban legends in DKA management, including VBGs vs ABGs, when to replete potassium, bicarb administration, and insulin boluses.
"Untoward patient-centered effects had not definitively been demonstrated until recently"Nick Johnson, MD (@NickJohnsonMD) discusses the recent evidence comparing isotonic saline with balanced fluids for resuscitation of septic patients.
"Set an alarm that gets your attention anytime someone presents with 'fever for 5 days'"Sean M. Fox, MD (@PedEMMorsels) with some excellent tips on recognizing factors putting your pediatric patients at risk for delayed diagnosis of Kawasaki Disease, including the more challenging to diagnose "incomplete" form of the disease.
"As one develops a skill set, FOAM becomes a more valued tool for fine-tuning your already engrained knowledge"Coverage of the FOAMed workshop at CORD 2014 from Adaira Landry, MD (@allarounddoc), with a primer on how to get involved in the social media and medical education movement.
"The LMA also serves as a well documented rescue device for 'can’t intubate, can’t ventilate' situations"Daniel Ostermayer, MD compares the various extraglottic airway devices available for adult and pediatric patients.
"Higher d-dimer levels correlate with more segments of the aorta involved, with false lumen type dissections, and with higher mortality rates"
D-dimer has great sensitivity for aortic dissection, but its true clinical utility in the workup of this high-risk diagnosis remains undefined. Tim Schaefer, MD reviews diagnosis and management, as well as the recent literature on the role of the d-dimer.
"It’s time to re-examine this recommendation"Epinephrine in cardiac arrest: helpful for ROSC, but maybe not so much for good neurological outcomes. Anand Swaminathan, MD MPH takes a thought-provoking look at the historical evidence behind this practice, as well as at newer evidence that calls its benefit into question.
