There is scant evidence published on the long-term outcomes of systemic thrombolysis in acute submassive PE. Many advocate for the use of systemic thrombolysis to reduce morbidity (complications from chronic pulmonary hypertension) and mortality. The PEITHO trial compared systemic thrombolysis (with tenecteplase + heparin) vs no systemic thrombolysis (placebo + heparin) in just over 1000 patients with confirmed PE,
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Journal Review
Long-Term Outcomes in Submassive PE After Thrombolytics
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Local Anesthetic Systemic Toxicity (LAST)
This post delves into local anesthetic systemic toxicity (LAST) syndrome with a focus on recognition and management.
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Journal Review
Prognostic Value of Fever in Severe Sepsis and Septic Shock
Sepsis remains a condition with a high mortality rate, and prompt recognition of the condition is essential. The presence and severity of fever raises suspicion for infection and is frequently a significant factor in medical decision making in the Emergency Department (ED). However, many septic patients are not febrile, which can impede prompt identification of critically ill patients.
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Core
Intertrochanteric Fractures
This post reviews the common intertrochanteric hip fracture focusing on diagnosis and management.
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Journal Review
The Vitamin C, Thiamine and Hydrocortisone Cocktail in Sepsis
While early recognition and treatment of sepsis has improved outcomes, mortality rates continue to be high. In low income countries, septic patients suffer mortality rates as high as 60%. Sepsis has been associated with vitamin c deficiency, with lower levels of vitamin c being associated with higher mortality rates. Prior studies targeting pathophysiological effects of sepsis have failed.
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Lisfranc Injuries
This post reviews the relatively common and often missed Lisfranc injuries.
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Trust Me.
“Just cut. He’s dead”, my senior resident calmly whispered behind me. I had walked through the crash chest tube hundreds of times in my head. I knew the steps like the back of my hand – fourth or fifth intercostal space, mid-to-anterior axillary line, cut above the rib, bluntly dissect with the Kellys, pop through the pleura,
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Journal Review
Initiation of Inhaled Corticosteroids During Peds ED Asthma Presentations
Asthma is a disease entity that all emergency department (ED) providers are expected to be able to manage both quickly and effectively. This is especially true in the pediatric population, where asthma is both the most common chronic disease of childhood and a leading reason for children to present to the ED.
In addition to mainstay therapies like beta-agonist inhalers and systemic steroids,
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