Value added wait time is a big focus for our patients, they want to get back home ASAP and stop being a patient. This study from the Annals of Emergency Medicine looks at the effects of waiting room work-ups. Pretty intuitive...they work! Initiating Diagnostic Studies on Patients c AP in the Waiting Room Decreases Time [...]
Management of Sepsis and Septic Shock: JAMA Clinical Guidelines Synopsis Howell MD, et al. JAMA 2017 Jan 19
This article serves as a counterpoint to my previous post calling into question current dogma around evidence based sepsis protocols. http://jamanetwork.com/journals/jama/article-abstract/2598892
I will admit to having been on the Rivers train (EGDT) and many subsequent iterations related to protocolized sepsis therapy for over a decade. This article by Josh Farkas does a good job of summarizing some different perspectives on the current state of evidence bases sepsis therapy. What it doesn't address is how protocolized sepsis [...]
Ever lose an IV...of COURSE you have. Read about a recent strategy here.
5. When diuretics may not be the place to start in the ED treatment of HF Management approaches for patients in the emergency department (ED) who present with acute heart failure (AHF) have largely focused on intravenous diuretics. Yet, the primary pathophysiologic derangement underlying AHF in many patients is not solely volume overload. Patients with [...]
Using RNA expression profiling to differentiate children with bacterial disease from those with viral disease
Clinicians who care for children have encountered the same questions for decades: does the child have an infection, is it likely bacterial or viral, and is an antibiotic indicated? These questions were further complicated by the “discovery” of bacteremia. Read the full article here