Research and Reviews in the Fastlane 194

This study questions the effectiveness of standard therapies (SQ insulin, IV fluids) in lowering blood glucose in type II DM patients who present to the ED with hyperglycemia but are otherwise well-appearing. Across 566 such encounters there was only an association with modest blood sugar reductions while significantly increasing the ED length of stay (in regards to IV fluid administration). Prior work from this group (https://www.ncbi.nlm.nih.gov/pubmed/27353284) questioned the value of lowering the blood sugar at all in well-appearing hyperglycemic type II diabetics. Add this to a lack of significant reduction and it may be time to put this approach to rest. Recommended by: Anand Swaminathan Toxicology Alam A, Juurlink DN. The prescription opioid epidemic: an overview for anesthesiologists. Canadian journal of anaesthesia. 2016; 63(1):61-8. PMID: 26507535 An excellent academic overview of the origins and extent of the prescription opioid crisis that Leon Gussow has called the “worst man-made epidemic in history”. The malign influence of drug companies and ‘thought leaders’ promoting the use of addictive drugs for a wide range of chronic pain conditions has been disastrous. The authors also review the evidence for the benefits and harms of longterm opioids. Recommended by: Chris Nickson Education Schwartzstein RM, Roberts DH. Saying Goodbye to Lectures in Medical School – Paradigm Shift or Passing Fad? The New England journal of medicine...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Airway Education Emergency Medicine R&R in the FASTLANE Toxicology and Toxinology clinical critical care EBM literature recommendations research and reviews Source Type: blogs