TXA has been the darling drug of emergency medicine and critical care since the publication of the CRASH 2 trial back in 2010. CRASH 2 demonstrated a 1.5% decrease in mortality when TXA was given to trauma patients with significant bleeding. (CRASH 2 2010) These results led to the widespread […]
In the Rapid Review series, I briefly review the key points of a clinical review paper. The topic this time: Leptospirosis
You can’t interpret the results of a test without knowing the pretest probability. I am sure we have all heard the same lecture about screening tests. I am sure that we have all been surprised by the strange numbers that result from applying seemingly excellent tests in low risk populations. […]
It’s time for another deep dive into the medical literature, this time looking at the evidence for heparin (or any anticoagulant) in the setting of STEMI and PCI. I have previously outlined the evidence that indicates that heparin shouldn’t be used (is harmful) in unstable angina and NSTEMI. However, that […]
I have addressed the WOMAN trial before on First10EM. (Twice actually). Two mentions of a trial of TXA in postpartum hemorrhage might already seem a bit excessive for an emergency medicine blog. However, this trial has been discussed widely, and there seems to be some persistent confusion about the results […]
It has been a busy day in your emergency department. The precipitous delivery that occurred at triage was complicated by shoulder dystocia. Luckily you had some help, and one of your colleagues is managing the neonatal resuscitation. Nurses are starting to congratulate mom and pat you on the back, when […]
I recently wrote a post lamenting our lack of attention to distress in adult patients. There is so much we can do to improve the emergency department experience. I am tempted to say that we should treat our patients as we would want to be treated – a variation on […]
The management of burn blisters has always produced a lot of debate. My teaching was to leave the blisters alone, as deroofing them provides no benefit but increases pain. Recently I have noticed a push to have burns debrided. Both in Canada and New Zealand, I have had plastic surgeons […]
Unfortunately, although the popularity of smoking has been on the decline for decades, vaping is becoming extremely popular, especially among young patients. More than 20% of high-school students and about 5% of middle school students admit to using an e-cigarette in the past 30 days. (Cullen 2018) When compared to smoking […]