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Research and Reviews in the Fastlane 062
This study is a meta-analysis looking at whether tamsulosin increases the rate of spontaneous stone passage in patients with renal colic. The authors report a benefit to the drug with a RR for passage of 1.50. However, this meta-analysis is significantly flawed as the studies entered into it had significant bias mainly due to issues with randomization as well as a high level of heterogeneity. This meta-analysis typifies the issue of garbage in equals garbage out and does not change the fact that tamsulosin has little good evidence to defend its use in these patients.Recommended by: Anand SwaminathanEmergency Medicine, Res...
Source: Life in the Fast Lane - December 17, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Education critical care emergency Emergency Medicine Intensive Care Press Ganey R&R in the FASTLANE recommendations Review Source Type: blogs

History and Importance of Procedural Medicine
Dr. Ault, considered a pioneer in procedural medicine, often used chickens as teaching tools in his courses. Over the past 30 years, the number of procedures performed by internists has steadily declined.1 Concordantly, the requirement to complete a minimum number of procedures during residency for board certification by the American Board of Internal Medicine was removed in 2007. As interest in performing procedures declined among internists and increased among other specialties, procedural medicine evolved into a profession all its own. Hospitalists have been at the forefront of this shift, developing medical procedure...
Source: The Hospitalist - August 1, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Education Hospital Medicine Practice Management Source Type: research

12th WINFOCUS world congress on ultrasound in emergency and critical care
Table of contentsA1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-Garc ía, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
Source: Critical Ultrasound Journal - September 6, 2016 Category: Radiology Source Type: research

Translating Guidelines into Practical Practice
Point-of-care ultrasound (POCUS) is now transitioning from an emerging technology to a standard of care for critically ill children. POCUS can provide immediate answers to clinical questions impacting management and outcomes within this fragile population. Recently published international guidelines specific to POCUS use in neonatal and pediatric critical care populations now complement previous Society of Critical Care Medicine guidelines. The authors review consensus statements within guidelines, identify important limitations to statements, and provide considerations for the successful implementation of POCUS in the ped...
Source: Critical Care Clinics - November 3, 2022 Category: Intensive Care Authors: Mark D. Weber, Joel K.B. Lim, Sarah Ginsburg, Thomas Conlon, Akira Nishisaki Source Type: research

Management of acute pediatric pain in the emergency department
This article provides a summary of recommendations for the multimodal and multidisciplinary approach to acute pediatric pain management and highlights recent research on this topic. Recent findings: Recent literature has focused on updating recommendations for the use of various analgesics in the pediatric population. While codeine is no longer recommended due to increasing evidence of adverse effects, the more liberal use of intranasal fentanyl is now encouraged because of the ease of administration and rapid delivery. The evidence base for the use of ultrasound-guided regional nerve blocks by qualified providers in the ...
Source: Current Opinion in Pediatrics - May 3, 2016 Category: Pediatrics Tags: EMERGENCY AND CRITICAL CARE MEDICINE: Edited by Jean Klig and Clifford W. Bogue Source Type: research

Critical care basic ultrasound learning goals for american anesthesiology critical care trainees: recommendations from an expert group.
DISCUSSION: Immediate bedside availability of ultrasound resources can dramatically improve the ability of critical care physicians to care for critically ill patients. Anesthesia--critical care medicine training should have definitive expectations and performance standards for basic CCUS interpretation by anesthesiology--critical care specialists. The learning goals in this review reflect current trends in the multispecialty critical care environment where ultrasound-based diagnostic strategies are already frequently applied. These competencies should be formally taught as part of an established anesthesiology-critical ca...
Source: Anesthesia and Analgesia - April 24, 2015 Category: Anesthesiology Authors: Fagley RE, Haney MF, Beraud AS, Comfere T, Kohl BA, Merkel MJ, Pustavoitau A, von Homeyer P, Wagner CE, Wall MH Tags: Anesth Analg Source Type: research

Publishing Trends in the Field of Pediatric Emergency Medicine From 2004 to 2013
Conclusions: By identifying these trends, we hope to encourage researchers to perform studies in the field of pediatric emergency medicine where deficiencies lie and to guide pediatric health care professionals to where published, evidence-based studies can be found in the medical literature.
Source: Pediatric Emergency Care - December 1, 2016 Category: Emergency Medicine Tags: Original Articles Source Type: research

Implementation and Evaluation of Training for Ultrasound-Guided Vascular Access to Small Vessels Using a Low-Cost Cadaver Model
Conclusions: Implementation of a skills training program for ultrasound-guided central venous catheterization in a cadaver tissue model was feasible and cost- and time-effective. The number of attempts until successful cannulation of small vessels (2-mm tube) was significantly lower after than before the standardized teaching program.
Source: Pediatric Critical Care Medicine - November 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Choice of Catheter Size for Infants in Continuous Renal Replacement Therapy: Bigger Is Not Always Better*
Conclusions: Small size central vascular catheters display optimal rheologic performances in terms of pressures and flows particularly when the renal replacement therapy device is equipped with pumps proportional to central vascular catheters sizes, and even when relatively high blood flows are set. This is achieved at the risk of a higher hemolysis rate.
Source: Pediatric Critical Care Medicine - March 1, 2019 Category: Pediatrics Tags: Online Laboratory Investigation Source Type: research

Guidelines for the Appropriate Use of Bedside General and Cardiac Ultrasonography in the Evaluation of Critically Ill Patients—Part II: Cardiac Ultrasonography
Conclusions: There was strong agreement among a large cohort of international experts regarding several class 1 recommendations for the use of bedside cardiac ultrasound, echocardiography, in the ICU. Evidence-based recommendations regarding the appropriate use of this technology are a step toward improving patient outcomes in relevant patients and guiding appropriate integration of ultrasound into critical care practice.
Source: Critical Care Medicine - May 17, 2016 Category: Emergency Medicine Tags: Special Article Source Type: research

Superiority of Dynamic Needle Tip Positioning for Ultrasound-Guided Peripheral Venous Catheterization in Patients Younger Than 2 Years Old: A Randomized Controlled Trial*
Conclusions: Dynamic needle tip positioning increased the first-attempt and overall success rates of ultrasound-guided peripheral venous catheterization in pediatric patients less than 2 years old.
Source: Pediatric Critical Care Medicine - September 1, 2019 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Case Studies in Pediatric Emergency and Critical Care Ultrasound
No abstract available
Source: Critical Care Medicine - October 16, 2014 Category: Emergency Medicine Tags: Online Book Reviews Source Type: research

Ultrasonographic Optic Nerve Sheath Diameter Measurement to Detect Intracranial Hypertension in Children With Neurological Injury: A Systematic Review
Conclusions: We are unable to identify a threshold value in ultrasound measured optic nerve sheath diameter for the determination of intracranial hypertension in children. Even though the ultrasound measured optic nerve sheath diameter measurement is highly sensitive to the presence of increased intracranial pressure, the test has only moderate specificity. Therefore, other confirmatory methods and further investigation is necessary in the clinical care of children. The technique is likely not sufficiently precise for clinical use in the absence of other confirmatory methods, and further investigation is necessary to det...
Source: Pediatric Critical Care Medicine - September 1, 2020 Category: Pediatrics Tags: Online Review Article Source Type: research

Pulmonary Critical Care Fellows' Use of and Self-reported Barriers to Learning Bedside Ultrasound During Training: Results of a National Survey.
Abstract BACKGROUND: Competence in ultrasound is essential for pulmonary and critical care medicine fellows, but little is known about fellow-reported barriers to acquiring this crucial skill during fellowship training. RESEARCH QUESTION: How do pulmonary and critical care fellows acquire experience performing and interpreting ultrasound during their training, what is their perspective on barriers to acquiring ultrasound expertise during fellowship, and what is their comfort with a range of ultrasound exams? STUDY DESIGN AND METHODS: A 20-item survey including questions about procedural training and acqu...
Source: Chest - February 1, 2021 Category: Respiratory Medicine Authors: Brady AK, Spitzer CR, Kelm D, Brosnahan SB, Latifi M, Burkart KM Tags: Chest Source Type: research

Critical Care Education and Skills Validation Course for Internal Medicine Physicians in the Military
CONCLUSIONS: Broad implementation of this program at military hospitals would improve pre-deployment critical care procedural readiness in military IM physicians.PMID:34164682 | DOI:10.1093/milmed/usab210
Source: Military Medicine - June 24, 2021 Category: International Medicine & Public Health Authors: Lauren A Sattler John C Hunninghake Tyson J Sjulin Michal J Sobieszczyk Maria M Molina Ana Elizabeth Markelz Robert J Walter Source Type: research