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In this review of patients admitted to the ICU with acute respiratory failure secondary to COPD exacerbation or cardiogenic pulmonary edema, nearly two-thirds of patients who apparently met criteria for noninvasive ventilation (NIV) were intubated without a trial of NIV.
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Institution of a daily pharmacist-enforced intervention designed to improve adherence to sedation guidelines decreased the duration of mechanical ventilation and ICU stay.
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Elevated troponin i is a nonspecific finding, but suggests a poor prognosis regardless of its cause.
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Ceftobiprole, a novel broad-spectrum cephalosporin with activity against MRSA, was non-inferior to vancomycin plus ceftazidime in a study of complicated skin and skin-structure infections. This is the first β-lactam with reliable activity against methicillin resistant Staphylococcus aureus (MRSA) to be evaluated in advanced-stage clinical trials.
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Randomized studies of neuroprotective agents for ischemic stroke have resulted in a series of failures, as multiple agents, promising in animal models, have failed when applied to human subjects. By contrast, intracerebral hemorrhage (ICH) has been somewhat a "neglected stepsister" when compared to ischemic stroke; it has been studied minimally, despite its high morbidity and mortality.
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A simple fall in a healthy person shouldn't result in multiple facial injuries, except if the patient was intoxicated, says Regina Curry, RN, an ED nurse at Thomas Jefferson University Hospital in Philadelphia. Instead, patients might break their wrist or skin their knees and hands from trying to break the fall, she says.
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Once a patient with violence-related traumatic injuries is stable and about to be discharged, you have to consider something equally important: Will he or she be safe after they leave your ED?
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If a patient complains of chest pain, you probably suspect a myocardial infarction (MI) and obtain an immediate electrocardiogram (EKG). But it doesn't show any signs of a heart attack. What do you do next?
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"Undiagnosed or new-onset seizure in infants is always a critical emergency, mostly because we need to figure out the underlying cause and treat it before it worsens," says Jennifer Anders, MD, an ED physician at Johns Hopkins Children's Center in Baltimore.
