There have been a few new thrombolytic RCTs since I published my review of the stroke literature, and it is probably about time that I got around to writing about them. On the one hand, I think it is exciting that we are moving past the flawed time-based selection of […]
EM literature (critical appraisals)
96 posts
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 […]
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 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 […]
It’s time for another edition of the research round up and BroomeDocs journal club – a collection of the most interesting emergency medicine research I have encountered in the last few months. This time around we have (of course) CRASH 3, some articles on laceration repair, improving the ED experience […]
Although the CT scan is a wonderful piece of technology that has undoubtedly improved the practice of emergency medicine, we are clearly over-using this technology in modern practice. For example, one study that looked retrospectively at all head CTs ordered for trauma concluded that more than 1/3 were unnecessary based […]