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Quick Hit Article

Its beginning to look a lot like…Research: Parachutes, Pharma and Golf; Oh My!

Its beginning to look a lot like…Research: Parachutes, Pharma and Golf; Oh My!

December 14, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Ahhh….December! While some people look forward to christmas music, jingle bells, Jack Frost and New Years, most of us (well maybe just me) see December as one of the most evidenced based times of the year! Yes every December the classic and so-very –British tongue in cheek version of the BMJ comes out to delight our …

Category: EBM, Quick Hit Article

Quick Hit Article #12: Should you stay or Should you go for syncope

Quick Hit Article #12: Should you stay or Should you go for syncope

November 26, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Anderson. Trends in Hospitalization, Readmission, and Diagnostic Testing of Patients Presenting to the Emergency Department With Syncope. Ann Emerg Med. 2018;72:523-532   Although this study doesn’t tell you who should be admitted it does nicely show the mortality, albeit inpatient only, and some interesting facts about admitted syncope patients. This was a retrospective epidemiology study of syncope-related …

Category: Quick Hit ArticleTag: Cardiology

QUICK HIT #11: WHAT TIDAL VOLUME SHOULD BE STARTED IN PATIENTS WITHOUT ARDS

QUICK HIT #11: WHAT TIDAL VOLUME SHOULD BE STARTED IN PATIENTS WITHOUT ARDS

November 22, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

QUICK HIT ARTICLE Effect of a Low vs. Intermediate Tidal Volume Strategy on Ventilator-Free Days in Intensive Care Unit Patients Without ARDS:
A Randomized Clinical Trial.
Writing Group for the PReVENT Investigators .  Simonis. JAMA. 2018; 320(18):1872-1880 All right pop quiz, hotshot. Altered patient gets intubated in the ED.  He’s almost to the ICU. The RT asks …

Category: Quick Hit ArticleTag: ICU, Pulmonology

QUICK HIT ARTICLE #10: How Low Should you Go? BP lowering without hypertensive emergency

September 18, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Miller, JB. Cerebrovascular risks with rapid blood pressure lowering in the absence of hypertensive emergency. Am J Emerg Med. 2018 Aug 21. pii: S0735-6757(18)30690-9. doi: 10.1016/j.ajem.2018.08.052. There are not many studies of affects of blood pressure lowering on ED patients in the absence of end organ disease. This one is an interesting one and should …

Category: Quick Hit ArticleTag: Cardiology

Quick Hit Article #9: Thiamine for severe sepsis? Yes, No and Maybe?

Quick Hit Article #9: Thiamine for severe sepsis? Yes, No and Maybe?

August 30, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Today’s quick hit article is probably the first in a long list of articles to come looking at Thiamine, vitamin C, or steroids for septic shock. Woolum. Effect of Thiamine Administration on Lactate Clearance and Mortality in Patients With Septic Shock. Critical Care Medicine 2018. Bottom Line: When compared in a chart review, patients with …

Category: Quick Hit ArticleTag: Biostatistics, ICU

Quick Hit Article #8: Say No To Flouro(Quinolone) in Pyelo

Quick Hit Article #8: Say No To Flouro(Quinolone) in Pyelo

August 27, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Quick Hit Article: Pyelonephritis treatment in the community emergency department: Cephalosporins vs. first-line agents. Vogler Am J Emerg Med. 2018 Aug 8. pii: S0735-6757(18)30652-1 The Bottom Line: In this retropsective chart review with moderate (not optimal) methods, patients placed on cephalosporins had significantly less treatment failure (0% vs 23%, p< 0.001) than when placed on either …

Category: Quick Hit ArticleTag: Infectious Diseases

(Really) Quick Hit Article #7 – LR does not clinically increase serum lactate. If you believe in lactate…come along with me…

(Really) Quick Hit Article #7 – LR does not clinically increase serum lactate.                If you believe in lactate…come along with me…

August 7, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Source: J Emerg Med. 2018 Jul 20. pii: S0736-4679(18)30602-4 Today’s (really) quick hit is a neat little article trying to answer the question “Does Lactated Ringers increase your serum lactic acid.  Given that sepsis seems to be the only diagnosis of anymore, can our friend lactic acid still help us if we are giving 30 ml/kg …

Category: Quick Hit ArticleTag: ICU, Infectious Diseases

Quick Hit Article #6:  How much insulin to give ESRD patients with Hyper K?

Quick Hit Article #6:  How much insulin to give ESRD patients with Hyper K?

August 5, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

One of the most physiologically complicated yet overly simplified “set it and forget it” protocols in emergency medicine just might be the acute treatment of hyperkalemia. We all have the protocol in our head and can write it up in our sleep (hopefully) but how effective is it? How safe is it? How evidenced based …

Category: Quick Hit ArticleTag: ICU, Renal

Quick Hit Article #5: Epi in cardiac arrest – Saving the heart! Saving the brain?

Quick Hit Article #5: Epi in cardiac arrest – Saving the heart! Saving the brain?

July 29, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

The long awaited (you were all waiting for it right?) PARAMEDIC2 trial for epinephrine in “out of hospital cardiac arrest” (OHCA) is finally here from the UK. We all know and love epi. We give it every 2-5 minutes in codes but why are we doing it? How well does it help us in return …

Category: Quick Hit ArticleTag: Cardiology, ICU

Quick Hit Article #4: Aspirin NOT tPA for mild strokes – Big Pharma at it again…

Quick Hit Article #4: Aspirin NOT tPA for mild strokes – Big Pharma at it again…

July 26, 2018 //  by Jesse Shriki, DO, MS RDMS FACEP//  Leave a Comment

Reference: Khatri P, Kleindorfer DO, Devlin T, et al. Effect of Alteplase vs Aspirin on Functional Outcome for Patients With Acute Ischemic Stroke and Minor Nondisabling Neurologic DeficitsThe PRISMS Randomized Clinical Trial. JAMA. 2018;320(2):156–166. doi:10.1001/jama.2018.8496 I love me some stroke! However, nothing gets me as riled up as much as a good ole tPA for stroke study …

Category: Quick Hit ArticleTag: Neurology, Stroke

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