Thrombocytopenia as a prognostic marker in septic shock
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - September 12, 2016 Category: Internal Medicine Tags: critical care hematology hospital medicine Source Type: blogs
LITFL Review 244
Welcome to the 244th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
A gold, silver, and bronze performance in one week. An epic non-clinical focus three-for from Don’t Forget the Bubbles: The impacts of bullying on kids; A call for action against asylum seeker abuse on Nauru; and the effect of adults bullying i...
Source: Life in the Fast Lane - August 14, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
LITFL Review 243
Welcome to the 243rd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
EM Nerd Rory Spiegel gives us statistical non-nerds an excellent and important education in descriptive statistic in a case of central tendencies. [SO]
The Best of #FOAMed Emergency Medicine
Ketofol or Propofol for procedural sedation i...
Source: Life in the Fast Lane - August 7, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs
We were promised death panels
The day was progressing swimmingly until the charge nurse announced we had an emergent exploratory laparotomy. These things happen; often there’s free air in the abdomen from a ruptured ulcer or diverticulum. Sometimes an exploratory laparotomy is necessary after trauma or a particularly nasty infection. We’re prepared to handle them.
“Where is the patient?” I inquired.
“On the way down from ICU. The surgeon’s on his way in,” I was told.
Hmm … they usually come from the E.D. This may not be typical.
I look up the elderly woman’s medical record on the computer. Two days post...
Source: Kevin, M.D. - Medical Weblog - July 18, 2016 Category: Journals (General) Authors: Physician on FIRE, MD Tags: Physician Hospital Intensive care Source Type: blogs
An Epidemic of Septicemia?
By AL LEWIS
While prevention efforts have largely been focused on chronic disease, spurred in part by the Centers for Disease Control and Prevention’s (CDC) insistence that 86% of healthcare dollars are spent on patients with chronic illness, it turns out that the largest, fastest-growing and possibly most preventable diagnosis is arguably the most acute diagnosis of all: septicemia.
Septicemia is any persistent systemic blood-borne bacterial infection, generally caused by contamination from an invasion of the bloodstream by an outside pathogen, and generally not easily addressed with antibiotics. Its many complications ...
Source: The Health Care Blog - June 17, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
The story of an exhausted doctor daughter
I am a doctor daughter. I am exhausted. My emotions are bubbling close to the surface, and I fear that at any moment, someone will do or say something to me that will cause me to lose control, which I’m not allowed to do because I’m also a female physician in a leadership role, and our emotions must be held in check.
I watched one of my mentors be memorialized last week after he lost his battle with cancer. This week, I will watch my father, a man who has meant more to me in my life than any other except my husband, go through a revision prostate surgery, a bone marrow biopsy, and an inpatient stay for a urinary tract ...
Source: Kevin, M.D. - Medical Weblog - May 12, 2016 Category: Journals (General) Authors: Shelley W. Collins, MD Tags: Physician Cancer Pediatrics Source Type: blogs
Research and Reviews in the Fastlane 125
Welcome to the 125th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check ou...
Source: Life in the Fast Lane - March 10, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology ECG Emergency Medicine Gastroenterology Intensive Care R&R in the FASTLANE critical care EBM Education literature recommendations research and reviews Source Type: blogs
LITFL Review 221
Welcome to the 221st LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Sepsis-3 is released, and a fantastic 7 minute vodcast from JAMA on their new consensus definitions for sepsis and septic shock. [SL] Here’s 40 minutes of sepsis goodness–iTunes interviews with the authors. [SO]
This is discussed by many ...
Source: Life in the Fast Lane - February 28, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Research and Reviews in the Fastlane 123
Welcome to the 123th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check ou...
Source: Life in the Fast Lane - February 24, 2016 Category: Emergency Medicine Authors: Soren Rudolph Tags: Airway Education Emergency Medicine Intensive Care R&R in the FASTLANE Resuscitation Toxicology and Toxinology Trauma critical care recommendations research and reviews Source Type: blogs
HPV Vaccines:
Health Professionals Caught Red-Handed in Hiding Serious Dangers
This is surely the most shameful act of all: While news of widespread lies and deceit in connection with promotion of HPV vaccines (Gardasil and Cervarix) is spreading rapidly across the world, a group of government officials and scientific and health professionals have collaborated to cunningly conceal information regarding serious dangers of the vaccines.
Evidence of the deceit was received by Dr. Sin Hang Lee, former Associate Professor at Yale University, pathologist of Milford Hospital, and director of the Milford Molecular Diagnostics Laboratory of Milford, Connecticut, and was published in a press release from San...
Source: vactruth.com - January 25, 2016 Category: Allergy & Immunology Authors: Sandy Lunoe Tags: Logical Recent Articles Sandy Lunoe Top Stories Cervarix Dr. Helen Petousis-Harris Dr. Margaret Chan Dr. Melinda Wharton Dr. Nabae Koji Dr. Robert Pless Dr. Sin Hang Lee gardasil HPV Vaccine Death Source Type: blogs
CCC Update 014
Updates to the CCC seem to be coming thick and fast these days.
Keep the feedback coming on this free guide to Critical Care encompassing over 1650 pages.
This is what has sprung up since CCC Update 013:
Mitchondrial dysfunction and mitochondrial diseases
About 1.5 billion years ago something extremely odd and extremely pivotal happened in our evolution. One cell enveloped another in an endosymbiotic union. The mitochondria were born, and they continue to be passed along by our mothers today. As the energy powerhouses of our cells, it makes sense that if they don’t work, then we are in big trouble. This manifests as...
Source: Life in the Fast Lane - January 13, 2016 Category: Emergency Medicine Authors: Chris Nickson Tags: Critical Care Compendium Education apnoeic oxygenation Delayed Sequence Intubation initial management of severe sepsis and septic shock mitchondrondrial dysfunction neutropaenic sepsis preoxygenation sepsis overview septic cardiomyopathy Source Type: blogs
LITFL Review 214
Welcome to the 214th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Should we be doing ultrasound-assisted catheter directed therapy (CDT) in submassive PE? Josh Farkas reviews the evidence and physiological explanation against the utility of this modality. [AS]
The Best of #FOAMed Emergency Medicine
Two excelle...
Source: Life in the Fast Lane - January 10, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
LITFL R&R – Best of 2015
This article is one more piece of the mounting evidence demonstrating a clear call to change what is the usual care in many institutions in the U.S. Stop the madness!
Chest pain is tough — it’s the second most ED common chief complaint, and it scares the heck out of us and our patients – partially because missed MI is one one of the top causes of litigation. But we also see a ton of resources spent on a terribly low yield from chest pain workups. This new study in JAMA-IM including Mike Weinstock (of Bounceback fame), Scott Weingart and David Newman looked at the bad outcomes of patients with normal ECG...
Source: Life in the Fast Lane - January 9, 2016 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Airway Anaesthetics Cardiology Education Emergency Medicine Intensive Care Pre-hospital / Retrieval R&R in the FASTLANE Respiratory Resuscitation Trauma critical care examination research and reviews Source Type: blogs
Research and Reviews in the Fastlane 111
This study from Canada looked at the ED diagnosis of concussion in a convenience sample of 495 kids within 2 weeks of head injury and found that compared to the Zurich criteria, ED physicians underdiagnosed concussion. ED physicians diagnosed concussion in 40.4% of the patients, while the Zurich criteria for concussion were fulfilled by 89.5%. Concussion was more likely to be diagnosed in kids >10 years old, those playing collision sports, those with an injury >1 day prior, or 3+ symptoms. This criteria, in this case defined by SCAT3 (not validated in all head trauma/cumbersome in ED), may represent another area of o...
Source: Life in the Fast Lane - December 3, 2015 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Airway Cardiology Emergency Medicine Infectious Disease Intensive Care Pediatrics Resuscitation Toxicology and Toxinology Trauma Urology critical care literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs
Research & Reviews in the Fastlane 107
This study suggests we’re even worse at it when the ED is busy. Researchers looked at 1116 hand hygiene opportunities presented to nurses, physicians and other healthcare professionals and used time to physician assessment as a marker of ED crowding. Mean hand hygiene compliance was only 29% but more worryingly longer mean time to physician assessment and higher nursing hours were associated with even lower compliance (24%). The bottom line? No matter how busy you are, WASH YOUR HANDS!
Recommended by Lauren Westafer, Natalie May
Emergency Medicine
Tseng HJ et al. Imaging Foreign Bodies: Ingested, Aspirated, and...
Source: Life in the Fast Lane - November 4, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Education Emergency Medicine Infectious Disease Intensive Care Neurology Pediatrics R&R in the FASTLANE Respiratory Resuscitation clinical critical care EBM FOAM literature recommendations research and reviews Source Type: blogs
