There are two massive problems with science publication, and maybe only one way to fix them. Any long time reader of this blog will have encountered me saying something like “this study should never have been published.” (See, for example, Andexanet Alfa: More garbage science in the New England Journal […]
Time for another semi-regular round-up of the top emergency medicine and critical care articles I have encountered over the last few months. This time we will tackle anti-epileptics, anti-emetics, the word “quiet”, and a whole bunch more…
Superstitions are sort of fun. They represent a lack of scientific understanding and critical thinking that I obviously hate, but they also offer us interesting and relatively harm free insights into the many failings of human cognition. I say “quiet” a lot. I like the word. Although it occasionally upsets […]
Case A 58 year old woman is brought in by EMS with acute onset respiratory distress. Over the last few hours, she has found it increasingly difficult to breathe. On arrival, she is diaphoretic and using accessory muscles. She is quite tachypneic at a rate of 45 breaths a minute, […]
In the classic algorithm for status epilepticus, we give 2 doses of a benzodiazepine followed by phenytoin. Since the introduction of levetiracetam, we have seen a lot of strong opinions about the best second line agent, but we never had much data. (I have argued that we actually need to […]
We have new evidence looking at the use of vasopressors through a peripheral IV. I have covered this topic before, and after reviewing the available literature in 2018, my conclusion was “I think it is clear that the administration of peripheral vasopressors is not only acceptable, but will occasionally be […]
I have written a lot about airway management on this blog. You can find the main 5 part series on emergency airway management starting here. I have also covered a prior Difficult Airway Society guideline on the intubation of critically ill patients here. One topic I have not spent a […]
I first heard of the concept of an emergency department integrated intensive care unit (or ED-ICU) from Scott Weingart on EMCrit. In my mind, this job sounds perfect. You get to manage the first few hours of undifferentiated critical illness. These hours are, in my mind, the most interesting in […]
I am not sure which I prescribe more often each shift: analgesics or antiemetics. Despite having medical directives for both, I am still interrupted multiple times every hour with requests to chart one or the other. To be fair, I am never bothered. Nausea and vomiting are horrible symptoms, and […]