Read the story 👇. It's so often that those of us who work in EM and critical care see devastating injuries and wonder whether we're really making a difference. SPC Jordan Kirkpatrick is a @usarmy Soldier who was riding his motorcycle on his day off when he had a high-speed

So what is an expected first-pass success for a new intern?. Well, if we assume that they have minimal previous airway experience (<30 intubations), then previous prospective data indicates:. FPS with DL = 30=60%.FPS with VL = 65-80%. #emergency

What do you want to know?.

You have a kid in septic shock. What MAP target do we aim for?. A study published this month randomized kids in septic shock to the 5th percentile mean blood pressure for age versus the 50th percentile. There were 144 kids randomized in an open-label design using art lines or

Should we do push-dose or infusion of norepi to prevent peri-intubation hypotension?. In this study published last month, they randomized 72 participants that were benign intubated for non-cardiac surgery to either push-dose via syringe (100ug pushes) or an infusion + boluses.

Should we routinely anticoagulate subsegmental PE's?. We say no. Find out why here:. (It's open access for the next month). #emergency #emergencymedicine #criticalcare #icu #science #data #research #army #armymedicine #armyemdoc #breath #breathe #lungs

How many of you routinely use the shock index pediatric age adjusted (SIPA)?. SIPA is more reliable than age-adjusted tachycardia in predicting major injury and overall severe injury (ISS>15). Here are the thresholds we should probably be using:.0-3 months, >2.0.4-6 months, >1.7

This recent systematic review with meta-analysis published last week with 21 studies containing nearly 42,000 patients, all of which were observational studies, found:.-Hypoxia was associated with worse mortality.-Hypocapnia was associated with worse mortality.-Hypercapnia had a

RT @EODHappyCaptain: This is a huge fact. The SGTs are the same age as you, but they aren’t your friends. They know more than you, but….

NAEMSP recently (this past week) released a position statement on the use of pelvic binders in the prehospital setting for suspected blunt pelvic fractures. Here's my gist of the summary:.-There is no good data demonstrating benefit with a potential signal for harm.-It is a

In this systematic review from last month, Von Hellmann et al found that opioid pre-treatment had an odds ratio of 2.15 (1.22-3.78) for peri-intubation hypotension. #emergency #emergencymedicine #criticalcare #icu #science #data #research #army

For those of you that like drinking coffee while on shift, do you drink cold brew or hot brew coffee?. I'm a hardcore cold brew fan. But which one yields more nutritional difference?. Unfortunately for me, the answer appears to be hot brew. Multiple studies have looked at the

The new ACEP clinical policy statement on emergency intubation is out. Here's the gist of their critical question recommendations:. -Use NIV over an oxygen mask for preoxygenation (level B), yay #PREOXI.-When you can't use NIV, use HFNC.-Use ketamine or etomidate for induction

In the setting of non-traumatic intracerebral hemorrhage, should we be lowering their blood pressure (<140mmHg) if they are hypertense or let it ride?. In this SR-MA published a few weeks ago, they analyzed data from 11 RCTs with almost 14,000 patients. They found benefit in

You've got a patient with an LVO pending thrombectomy. Should you lay them supine/flat or elevated the HOB 30 degrees?. In this RCT that was stopped early due to safety, they found that laying the patient supine/flat resulted in:.-Stopped early by DSMB after enrollment of 92 out

Can neurofilament light chain measurements predict neurological outcome after OHCA?. There have been numerous studies on this, but large validation datasets were lacking. This study was a secondary analysis of a prospective RCT in Denmark. They defined poor neurological outcome

RT @reverendofdoubt: Can breast surgeons stop telling patients their arm is off limits for vascular access— this causes way more harm than….

In our analysis of >200,000 kids in the US, we found that a whopping 1 in 7 would have significant under-estimation of drugs that are based on actual body weight (e.g. rocuronium). This is not an issue for drugs that are dosed based on ideal body weight, but drugs like

PSA: Reminder. if you use rocuronium for RSI, remember that your paralysis will grossly outlast the sedative. Always have your chaser sedation ready to go!. Standard dose rocuronium (0.6-1.2mg/kg) = 60 minutes duration.My preferred dose rocuronium (1.5-2.0mg/kg) = 2 hours.

In EM, we love decision tools. so I'll start covering the ones I find most useful. PERC = Pulmonary Embolism Rule Out criteria. If you answer no to all of these questions, the rule has a pooled sensitivity (good for 'ruling out') 97% (CI 96-98%) in a low risk population, which

How often do chest wall injuries happen after CPR? In this study, nearly 1 in 4. Out of the 101 patients there:.20 sternal fractures.49 anterior flail segments.2 lateral flail segments.81 right side rib fractures.78 left side rib fractures. Probably unsurprisingly, the ones