Tamiflu doesn’t work – at least not for anything important. In fact, because of its many side effects, it is probably harmful. For anyone following this evidence based debacle over the last decade, I think that conclusion is pretty clear. You can read a little bit about the Tamiflu saga […]
Since my rather lengthy write up of the stroke literature, there have been new RCTs published looking at thrombolytics for acute ischemic stroke. No, we haven’t got the replication of NINDS that we so desperately need. However, the new trials do represent a step forward in our thinking about stroke: […]
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 […]
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 […]