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EMCrit 150 – A Look Back
Can’t believe we made it this far…and it’s all thanks to the emcritters!
Dear NEJM: We both know that conflicts of interest matter.
0 Introduction 0 Recently the New England Journal of Medicine launched a media campaign challenging the negative perception of industry conflicts of interests (COI). This was surprising, because it is the opposite of what editors of the NEJM have previously reported (see above books by former NEJM editors, published in 2004 and 2005). Big pharma […]
Do Patients with COPD Exac need a PE Workup?
Do Patients with COPD Exac need a PE Workup?
Books I Recommend – May 2015
From time to time, I recommend books on the site. These are books I have read and can recommend to all of you
Pneumonia, BiPAP, secretions, and HFNC: New lessons from FLORALI
Introduction 0 Pneumonia is extremely common. Nonetheless, there is surprisingly little evidence about supporting pneumonia patients using bi-level positive airway pressure (BiPAP) or high-flow nasal cannula (HFNC). The recent FLORALI study offers new insight into this. This post will explore how BiPAP and HFNC compare for pneumonia patients, prior evidence, and the FLORALI study. 0 […]
More on the Rapid Saphenous Cutdown for Vascular Access in Trauma
Rapid Saphenous Cutdown Video
Top 10 reasons to stop cooling to 33C
Introduction 0 Following the Nielsen study, many hospitals developed two protocols for temperature management after cardiac arrest (33C or 36C). For example, the 36C protocol could be used for patients with contraindications to hypothermia (33C). With ongoing evidence emerging about hypothermia, many hospitals are abandoning their 33C protocols and using 36C for all post-arrest patients. […]
EMCrit 149 – Thyroid Storm
When hyperthyroidism goes really wrong…
Stuff Update
A whole bunch of stuff
Apneic ventilation using pressure-limited ventilation
Introduction 0 Noninvasive ventilation (i.e. BiPAP) is arguably the most powerful approach to optimize oxygenation and ventilation before intubation, given its ability to provide 100% FiO2, PEEP, and ventilatory support. The only way to improve upon this is to extend the administration of positive pressure ventilation throughout sedation and paralysis, right up until the moment […]
The Third Annotation of a Case of Identity
So often in modern medicine we mistake science for truth. In doing so we have become enamored with the p-value and view it as the major determinant of relevance in scientific inquiry. An almost arbitrary selected value of 0.05 is independently responsible for defining what is considered beneficial, and what will be discarded as medical […]
What is the evidence behind the IVC filter?
Introduction 0 Until recently, recommendations regarding IVC filters have been based predominantly on a singleRCT (PREPIC-1). Last week, a second RCT was released in JAMA (PREPIC-2). This post will review both studies. What is the evidence basis for using IVC filters? 0 PREPIC-1 (Decousus et al. A clinical trial of vena caval filters in the […]
Surgical Intensive Care Unit Orientation
SICU Resources
Cognitive approach to shock diagnosis using ultrasonography
0 Recently I coauthored an article about the bedside evaluation of shock using ultrasonography. It’s a reasonable article, albeit conventional. Below is a summary of the key points. 0 Many textbooks recommend line-box algorithms for approaching a patient with shock, for example the ACES algorithm below. These algorithms allow the operator to reach a diagnosis based […]
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