Category Archives: 1Intermediate

Transfusion Strategies for Acute Upper Gastrointestinal Bleeding

Summarized by Trevor Pour MD Transfusion Strategies for Acute Upper Gastrointestinal Bleeding, N Engl J Med. 2013 Jan 3;368(1):11-21 Background Upper GI bleed is a common emergency condition with wide ranging severity. There is some controversy regarding hemoglobin transfusion thresholds … Continue reading

Posted in 1Intermediate, GI, NEJM, pediatrics | Leave a comment

Bleeding Patients on Dabigatran aka Pradaxa

By Dr. Ling Zang, MD Please refer to Indication: stroke prevention in atrial fibrillation Mechanism of action: reversible, competitive, direct thrombin inhibitor (downstream from other anticoagulants) Pharmacokinetics: Half time: 13 hours in patients with normal renal function (Cr clearance > … Continue reading

Posted in 1Intermediate, hematology | Leave a comment

Critical Care Palliation with Ashley Shreves

By Gene Schiappa, MD Please refer to EMCrit As terminal disease course progresses: Disease driven care: decrease Palliative care : increase   Overall care required may increase. Patients and family require additional assistance and services.   3 areas of improvement … Continue reading

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Validation of San Francisco Syncope Rule

Summarized By Raviraj Patel, MD Source: Quinn J, McDermott D, Stiell I “Prospective Validation of the San Francisco Syncope rule to Predict Patients With Serious Outcomes.” Annals of Emergency Medicine, Vol 47, No. 5: May 2006 Intro Syncope accounts for … Continue reading

Posted in 1Intermediate, Annals, Cardiology | Leave a comment

Erasing Death

By Sabrina Schmitz, MD “Erasing Death” Explores the Science of Resuscitation (NPR—Feb 20, 2013) SUMMARY:   This is an NPR interview of Dr. Sam Parnia, Director of Resuscitation Medicine at Stony Brook, in which he discusses ideas presented in his … Continue reading

Posted in 1Advanced, 1Beginner, 1Intermediate, Critical Care, Resuscitation | Leave a comment

TCA Overdose

By Christie Lech, MD Please refer to EMRAP Classically, you see a wide QRS complex and a tall R wave in aVr (elevation in the terminal 40 msec of aVr) Treatment of your sick, dying TCA overdose patient – lots … Continue reading

Posted in 1Intermediate, Cardiology, EMRAP, Toxicology | Leave a comment

ACS Updates

By Amy Sanghvi, MD Please refer to EMRAP Updated UA on NSTEMI guidelines. Focused update from Guidelines from 2007. Done to focus on new issues relative to antiplatelet medications: Ticagralor and Prasugrel (Effient). Many using Prasugrel instead of clopidogrel. P2Y12 … Continue reading

Posted in 1Intermediate, Cardiology, Chest pain, EMRAP | Leave a comment

Post Cardiac Arrest Syndrome: a review of therapeutic strategies

Stub D, Bernard S, Duffy SJ, Kaye DM. Circulation. 2011 Apr 5; 123(13):1428-35   By Felipe Teran, MD   Article capsule The significant morbidity and mortality associated with patients who survive to an Out-of-Hospital Cardiac Arrest (OHCA) has driven the … Continue reading

Posted in 1Intermediate, Cardiology, Critical Care, Hypothermia, Resuscitation | Leave a comment

Crash-2

By Nelson Wong, MD Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomized, placebo-controlled trial Lancet 2010;376:23-32 Background Trauma is a major cause of death worldwide.  Lethal triad … Continue reading

Posted in 1Intermediate, Resuscitation, Trauma | Leave a comment

Severe Trauma with Karim Brohi

By George Lim, MD Please refer to EMCrit PERMISSIVE HYPOTENSION -       For Dr. Brohi, permissive hypotension is more of a mindset more so than goal BP’s If he had to give number, SBP < 60 or 70 then provide crystalloid/blood … Continue reading

Posted in 1Intermediate, EMCRIT, Trauma | Leave a comment