A summary of the evidence for (or against) epinephrine (adrenaline) in out of hospital cardiac arrest
The most recent episode of Emergency Medicine Cases Journal Jam takes a look at the evidence for epinephrine in cardiac arrest. (I suppose as I prepare for my move to New Zealand, I should probably get used to using the term adrenaline, but for now I will stick with the Canadian “epinephrine”.) These are the written notes to accompany that podcast.
Continue reading “Epinephrine in out of hospital cardiac arrest: a review of all the evidence”
A monthly (ish) summary of the emergency medicine literature
Given than it has been 3 months since the last version, I think it has officially become ridiculous to call these posts “articles of the month”. This is a summary of the papers Casey and I discussed for the BroomeDocs Journal Club. Most of the papers will have been covered in individual blog posts, but there are always a few gems thrown in to keep things interesting.
Continue reading “Research Roundup (formerly articles of the month)”
A rant about guidelines (and an opportunity to help shape the future of the ILCOR guideline process)
I hate guidelines. I shouldn’t. In theory, summaries of the medical literature that are accessible to practicing clinicians could only be good. Unfortunately, in current practice, medical guidelines are too often biased, unscientific, overreaching, or misleading.
Continue reading “I hate guidelines (but they can improve and you can help)”
A response to and discussion of a critique of evidence based medicine (EBM)
A recent podcast has caused a bit of a stir among the nerdiest of my friends. This post, in large part, is a response to that podcast, but more than that, it is a discussion of the role of science and evidence in modern medicine, so you might find it interesting even if you haven’t heard to podcast I am talking about.
Continue reading “Evidence based medicine is still the best kind of medicine”
A brief summary of the COMBAT trial looking at prehospital plasma for trauma resuscitation.
A couple weeks ago I covered the PAMPer trial, which demonstrate a potentially “unbelievable” 10% decrease in mortality by using plasma as the primary resuscitation fluid prehospital in trauma patients being transferred by air. I was somewhat skeptical (surprising I know) of the result. This is a similar study, but with different conclusions.
Continue reading “Another trial of prehospital plasma for trauma (COMBAT)”
A review of the SALT-ED trial (Self 2018) comparing 0.9% saline to balanced IV fluids in an emergency department setting
So far, this week’s discussion of IV fluid choice has focused on ICU patients in our discussion of both the SPLIT and SMART trials. I work in the emergency department and really want to know how to manage emergency department patients. To close out IV fluids week, we will look at the SALT-ED trial, which was run by the same group and at the same hospital group as the SMART trial, but focused on patients in the emergency department.
Continue reading “IV fluid choice part 3: The SALT-ED trial”
A review of the SMART trial (Semler 2018) comparing 0.9% saline to balanced crystalloid
Yesterday, I covered the SPLIT trial, comparing saline with Plasma-Lyte 148. Today we are going to look at SMART, the trial that provoked the numerous cringe-worthy popular headlines…
Continue reading “IV fluid choice part 2: The SMART trial”