All the lit goodness for Feb 2023
Search Results for: lamw
EMCrit – RACC Lit Review Oct/Nov 2022
Oct/Nov 2022
EMCrit 226 – Airway Update – Bougie and Positioning
A discussion of bougie-first, bougie best and hopefully a summary of proper positioning
Preoxygenation & apneic oxygenation using a nasal cannula
0 Starting Point: We do a bad job at preoxygenation 0 We could do better at preoxygenating patients before emergent intubations. In my experience the most commonly used device for preoxygenation is a bag-valve mask, which has many pitfalls. We often accept a poor mask seal in efforts to remain gentle with awake patients. […]
A Rant on Video Laryngoscopy
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The Adventure of the Speckled Band
Blood pressure is one of the least understood and yet most intervened on metrics in modern medicine. Though we have found meager success in controlling blood pressure over the long-term (1,2) our attempts to translate these benefits to the acute setting of the emergency room have not been met with improved short-term outcomes. Traditionally acutely […]
The Ties that Bind: Social Capital and the Psychology of FOAM by Mike Lauria
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High-flow nasal cannula for apneic oxyventilation
0 Introduction 0 Last summer I wrote a postabout preoxygenation and apneic oxygenation using high-flow nasal cannula (HFNC). At that point there was no evidence supporting it, so the post was based primarily on the physiology of HFNC. Recently two papers were published supporting the use of HFNC for preoxygenation and apneic oxygenation (Patel 2015, […]
PulmCrit- DEXACET: Four grams of acetaminophen a day keeps the delirium away?
For decades, acetaminophen has been regarded as the first rung of the analgesic ladder. It has a nearly unparalleled risk/benefit profile when dosed correctly (it’s not tremendously effective, but it is extraordinarily safe). Theoretically, acetaminophen should be used very broadly among critically ill patients with pain.However, this isn’t the case.
EMCrit 296 – The French Connection, Part 1 – Resuscitation Geography, Logistics, & Ergonomics
A new series on the philosophy and psychology of resuscitation…
The Case of the Non-inferior Inferiority
The practice of Frequentist statistics is often a study in extremes. Based on an arbitrary threshold of significance, we are asked to interpret data as either positive or negative when in reality it merely shifts our probability of certainty. Even more important, because of the singular nature of Frequentist statistics, our interpretation of data is […]
PulmCrit- Alpha-2 agonists: clonidine, guanfacine, lofexidine, and KetaDex
Dexmedetomidine is an intravenous alpha-2 agonist used as a sedative infusion. It has some uniquely useful properties, particularly that it doesn’t suppress respiration (allowing it to be safely used in non-intubated patients). The main drawbacks of dexmedetomidine are logistic: it is expensive and can be administered only as an IV infusion within an ED or ICU. Oral clonidine offers some similar benefits compared to dexmedetomidine, without these logistic constraints.
COVID Airway Management Thoughts
additional COVID airway management thoughts
PulmCrit – A history of hypothermia for cardiac arrest, 2002-2021 (RIP)
Let’s start by considering what our pretest probability should be regarding whether hypothermia is beneficial after cardiac arrest. Every enzyme in our body has been evolutionarily designed to function at our normal body temperature. Therefore, hypothermia will affect every chemical pathway. As such, hypothermia is an incredibly blunt tool. It’s hard to think of any […]
Thoracic Radiology – Distribution of parenchymal abnormalities
CONTENTS Peripheral vs. central Peripheral Peripheral consolidation ➡️ Central Peribronchovascular Upper vs. lower Upper lung predominant Midlung predominant Lower lung predominant Migratory infiltrates Distribution of bronchiectasis ➡️ Questions & discussion abbreviations used in the pulmonary section: AE-ILD: Acute exacerbation of ILD 📖 AIP: Acute interstitial pneumonia (Hamman-Rich syndrome) 📖 ANA: Antinuclear antibody 📖 ANCA: Antineutrophil […]
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