Pneumonia, an acute infection of the pulmonary parenchyma, is a disease that commonly presents to US Emergency Departments, with an incidence as high as 9.7 per 1000 persons in developed countries. Studies have found that community acquired pneumonia alone has a hospitalization rate of 46.5% and 30-day mortality of 12.9%, with a case fatality rate of over 50% in patients with pneumonia-related sepsis/septic shock (Kolditz 2016,
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Journal Review
Utility of quick sepsis-related organ failure assessment (qSOFA) to predict outcome in patients with pneumonia
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Forearm Fractures
This post reviews common forearm fractures including the Monteggia and Galeazzi fractures.
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Journal Review
Idarucizumab for Dabigatran Reversal II
Dabigatran is an oral direct thrombin inhibitor, touted as non-inferior to Warfarin (though there is some debate about its safety (Yao, Abraham et al. 2016, Hernandez, Baik et al. 2018). It is now routinely prescribed for the treatment of non-valvular atrial fibrillation, venous thromboembolism (VTE) and post-surgical prophylaxis. Dabigatran blocks the last stages of the coagulation cascade,
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Topics in Post-ROSC Care
This post explores controversial topics in post-ROSC care including the use of NCHCT, hemodynamic goals and cardiac catheterization
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Journal Review
IO vs. IV in Out-of-Hospital Cardiac Arrest (OHCA)
This Journal Review is cross-posted on REBEL EM.
Placement of vascular access for administration of resuscitation drugs and fluids is a common procedure in the management of out of hospital cardiac arrest (OHCA). While intravenous (IV) placement has been the standard approach for decades, intraosseous (IO) access is rapid and safe and may be the preferred approach due to fact that the bone marrow does not collapse during shock states as peripheral veins often do.
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Metacarpal Fractures
This post explores metacarpal fractures with a focus on presentation and management.
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Journal Review
Apneic Oxygenation in the ICU
Hypoxemia is the most common complication of endotracheal intubation in the critically ill and the strongest risk factor for periprocedural cardiac arrest and death. The traditional approach to avoiding desaturation during intubation is preoxygenation. However, in critically ill patients, acute physiologic abnormalities render preoxygenation less effective. Apneic oxygenation is the delivery of supplemental oxygen to the nasopharynx in the absence of ventilation.
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Acute Pancreatitis
This post explores the diagnosis and critical steps in the management of pancreatitis.
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