Author Archives: plw6y

Sepsis for CMS

On Oct 1, 2015 CMS began requiring hospitals to report their data on how they meet certain metrics for patients with “severe sepsis” via Sepsis Bundle Project v 5.0a. As with everything CMS, the details are things we need to … Continue reading

Posted in Critical Care | Tagged

EM ONE – September Update – Changing SUX to ROC

So this post is not about new data, but a new way of practicing emergency medicine.  Our EMS system will be switching from using Succinylcholine (SUX) to using Rocuronium (ROC) on selected intubated patients next month. Below is the data behind the decision, which … Continue reading

Posted in Uncategorized

Rocuronium vs Succinylcholine for Intubation

Practice Changer: I will be using ROC at 1.2mg/kg in my ED patients who do NOT require repeat neurological examination.  It has no contraindications, is equally effective to SUX, and will give me LONGER SAFE APNEIC TIME to secure the airway. … Continue reading

Posted in Uncategorized | Tagged ,

EM ONE – August Update – Cardiology

Hey Everyone – Our recently adopted HEART score has a new twist, the HEART Pathway, that may be perfect for US ED use.  While our cardiology colleagues may have fewer chest pain consults, the new AHA guidelines for out of hospital … Continue reading

Posted in Uncategorized

PCI after Cardiac Arrest

Practice Change:  After an ECG, ABG, and beside electrolytes all comatose post-arrest patients with ROSC should be discussed with the cardiologist for emergency PCI – up to 25% may benefit.  Cardiac Arrest: A Treatment Algorithm for Emergent Invasive Cardiac Procedures in the Resuscitated Comatose Patient JACC – … Continue reading

Posted in Uncategorized | Tagged ,

HEART PATHWAY for Cardiac Risk

Practice Changer: The HEART Pathway is a simple cardiac risk assessment tool that is designed for use in the ED.  It’s safe and effective at classifying patients as low risk for outpatient evaluation of cardiac disease while also decreasing length of stay and … Continue reading

Posted in Uncategorized | Tagged ,

EM ONE – July Update – Shhhh… the baby’s sleeping!

To Clot or NOT to Clot? July 2015 Articles Reviewed Age Adjusted D-dimer in PE evaluation ** Tranexamic Acid in Trauma CRASH II – initial protocol** Timing is important!** Head Injury In a trauma system Military Data (less applicable, but supportive … Continue reading

Posted in Monthly THUMBNAIL | Leave a comment