Special thank you to Salim Rezaie for guest editing this post.
Out-of-hospital cardiac arrest (OHCA) affects > 300,000 people in the US each year and most of these patients are transported to the Emergency Department (ED) for further care. Currently, survival to discharge sits at around 8%. Over the last decade, it has become clear that the keys to improved return of spontaneous circulation (ROSC) and return of neurologic function (RONF) are early CPR,
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Cardiac arrest is common occurrence effecting > 300,000 Americans each year and with a generally dismal prognosis (survival rate 7-9%). Currently, there is an absence of evidence or guidelines to aid physicians’ regarding the timing of resuscitation termination when patients do not obtain return of spontaneous circulation (ROSC). Point-of-care ultrasound (POCUS) has been useful in other critical patients such as in trauma or undifferentiated shock.
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Thanks to Rory Spiegel for providing peer review for this post.
This post is cross-posted on REBEL EM.
Ureteric (renal) colic is a common, painful condition encountered in the Emergency Department (ED). Sustained contraction of smooth muscle in the ureter as a kidney stone passes the length of the ureter leads to pain.
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Pulmonary embolism (PE) kills 100,000 people in the United States each year making it the second most common cause of sudden, unexpected, nontraumatic death outside of the hospital. PE-related deaths can be unexpected because it can present with minimal symptoms, vague symptoms, difficulty breathing, syncope, or sudden-death. Among ED patients with PE, about 3%-4% have had a syncopal event.
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Diverticulitis is a common cause of abdominal pain in the Emergency Department (ED) setting, especially in older patients. It has been reported as one of the 5 GI diseases most burdensome to the healthcare system at large in the United States. Diverticulitis is defined as inflammation of one or more diverticuli; outpouchings of the large intestine caused by herniation of the bowel mucosa into the colon wall.
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Although ibuprofen has been shown to be an effective analgesic for children with extremity fractures, controversy exists as to whether its use may be detrimental to fracture healing. This is problematic as common alternatives, specifically acetaminophen and opiates, can be ineffective or have troublesome side effects. This study aims to shed light on the possible association between NSAIDs and fracture complications in pediatric patients.
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While hypoxia is a clearly recognized dangerous clinical entity in critically ill patients, the dangers of hyperoxia are gaining recognition. Hyperoxia has been shown to cause systemic vasoconstriction, pulmonary interstitial fibrosis, atelectasis, and tracheobronchitis. Two studies have demonstrated the harms of hyperoxia in both peri-operative (Meyhoff 2009) and STEMI patients (Stub 2015). This study sought to look at the effect of conservative arterial oxygen goals on ICU mortality.
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