150 Lives in 150 Days


My friend, David Sweet, is an ED Intensivist and the clinical lead of the British Columbia Sepsis Network. Their motto, “Best care, no matter where.”–you can see why we get along.

They put together an initiative to save 150 lives in 150 days. With a NNT of 5, they needed to treat 750 patients in ~5 months in order to save the requisite number of patients… And they did it.

Here is David:

This past World Sepsis Day, in British Columbia, Canada, the BC Sepsis Network launched an awareness and engagement campaign to accelerate the use of evidence-based sepsis management in the province. In 150 days, 32 emergency departments signed up and used a sepsis early identification/treatment protocol to treat 750 patients with severe sepsis (lactate >4.0 mmol/L) or septic shock (hypotension). Based on a number needed to treat of five, we saved 150 Lives in 150 Days!

Kudos brother!

Check out their Poster

Which Airway Mannequin for Resuscitationists?

Who would know better than Minh Le Cong? He recommends this particular model from Nasco (as always neither of us have any COI).

Nasco Critical Airway Manager


Minh has beaten the crap our of his, drowned it, and basically committed levels of abuse that would get him arrested in a more civilized country.

Also Checkout the Cool DIY Work by Jim DuCanto, MD


US Emergency Physicians Must Read this Piece


Please, please take the five minutes to read this piece on malpractice from EP Monthly:

‘Gross Negligence’: A Slippery Slope for Dubious Expert Testimony

PDF version of Gross Negligence Article

image by quinn.anya

2014 Cabo CME Retreat

Join Rich Levitan, Mike Mallin, Matt Dawson, Rob Orman, Andy Sloas, and me for a 5-star, all-inclusive vacation in beautiful Cabo San Lucas and earn your CME credits in style. You’ll meet other leading medical professionals, enjoy luxury resort treatment, and learn about the latest advancements in emergency medicine at this exclusive medical retreat. The 2014 Cabo CME Retreat will focus on the newest emergency medical practices and technologies in the areas of ultrasound and airway medicine.

Our lineup of leading emergency doctors and medical speakers will present at Secret’s Resort, the newest all inclusive luxury resort in San Jose del Cabo. Secrets Puerto Los Cabos Golf & Spa Resort boasts five gourmet restaurants, incredible views, infinity pools, and world renowned golf courses designed by Greg Norman and Jack Nicklaus. At this limited-access retreat, you will experience a CME conference unlike any other.

Want More Information?

Go to the Cabo CME Home Page


SMACC Gold Promo


I interview Roger Harris about SMACC Gold. Come to smacc.net.au to hear more.


Do the New Non-Ionic Contrast Agents Actually Cause Renal Failure?

This question is discussed in an excellent post on the ED Trauma and Critical Care blog. Amit reviews these four articles:

  1. Newhouse, J. H. & RoyChoudhury, A. (2013). Quantitating Contrast Medium-induced Nephropathy: Controlling the Controls. Radiology, 267(1), 4–8. doi:10.1148/radiol.13122876
  2. McDonald, J. S., McDonald, R. J., Comin, J., Williamson, E. E., Katzberg, R. W., Murad, H. M., & Kalimes, D. F. (2013). Frequency of acute Kidney injury Following intravenous contrast Medium administration: A Systematic Review and Meta-Analysis. Radiology, 267(1), 119–128. doi:10.1148/radiol.12121460/-/DC1
  3. McDonald, R. J., McDonald, J. S., Bida, J. P., Carter, R. E., Fleming, C. J., Misra, S., et al. (2013). intravenous contrast Material–induced nephropathy: Causal or Coincident Phenomenon? Radiology, 267, 106–118. doi:10.1148/radiol.12121823/-/DC1
  4. Davenport, M. S., Khalatbari, S., Dillman, J. R., Cohan, R. H., Caoili, E. M., & Ellis, J. H. (2013). Contrast Material-induced Nephrotoxicity and Intravenous Low-Osmolality Iodinated Contrast Material. Radiology, 267(1), 94–105. doi:10.1148/radiol.12121394

His conclusion…Probably not. It is probably merely association. But click over to his post and read it all.

Induced Normothermia After TBI

Vodcast on Applying to Crit Care Fellowship from EM

From the SCCM EM Section with my friends Tim Ellender and Lil Emlet. If yo are thinking of going for critical care fellowship, check it out ASAP

Link to the SCCM Vodcast

Vaughan Williams Video

Since we were talking about Na-channels in the last podcast, Sean Smith suggested this video:

The LLS Score

MDCalc is where I go when I need to remember a clinical scoring system. I was thus quite pleased to find one of the scores I use every shift appear on the site. The LLS score is how I determine the need for many interventions, but especially to decide who needs massive transfusion.

LLS Sign