CHEST Transfusion Thresholds | Paralytic or Sedative First?

The JournalFeed podcast for the week of Dec 16-20, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday Spoon Feed: This article breaks down patient selection, setup, special considerations, and step-by step instructions to manage awake intubations, a rarely utilized but essential technique in emergency airway management.Tuesday Spoon Feed:This large retrospective database study found a 28% increased risk of mortality in patients intubated with etomidate.

The JournalFeed podcast for the week of Dec 9-13, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday Spoon Feed:A post-hoc analysis of 3 studies conducted in Europe (PROPER, MODIGLIANI, TRYSPEED) analyzed patients with a high pretest probability for PE based on Wells’ or revised Geneva score and found that using D-dimer alone would have missed 0 PEs, but this strategy is not ready for primetime.Tuesday Spoon Feed:An open-label, multicenter RCT found that patients with severe brain injury who were mechanically ventilated had a worse composite outcome if they were ventilated with a lung protective strategy compared to a conventional strategy. This study was underpowered and stopped early secondary to funding issues. 

The JournalFeed podcast for the week of Dec 2-6, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Wednesday Spoon Feed:This animal model study compared the classic median bar technique for zipper skin entrapment release to a novel approach. There was no upside or downside to using the new technique.Thursday Spoon Feed:There is a very low likelihood of missing aneurysmal SAH if CT brain imaging is obtained within 24 hours of symptoms onset, but these results are not enough to change practice.

The JournalFeed podcast for the week of Nov 25-29, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday Spoon Feed:This secondary analysis of 2 RCTs found no significant difference between rocuronium or succinylcholine on first attempt success or severe complications in critically ill patients undergoing endotracheal intubation. Wednesday Spoon Feed:Acute pericarditis is a common cause of nonischemic chest pain. In North America, it is typically idiopathic, develops after a viral infection, or follows a cardiac procedure. In areas with higher prevalence, tuberculosis can be an underlying cause of pericarditis. For the majority of patients, treatment with NSAIDs and colchicine leads to a favorable prognosis.

The JournalFeed podcast for the week of Nov 18-22, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday Spoon Feed:Most of the time, targeting a hemoglobin threshold of 7 – 8 g/dL in critically-ill patients is recommended, with acute coronary syndrome as the exception to the rule. Strap in for this longer-than-normal Spoon Feed summary of these guidelines.Wednesday Spoon Feed:This study utilized Bayesian analysis and found that when paralytic medications were administered before sedatives during ED intubation, there was an association with decreased first attempt failure rate. 

The JournalFeed podcast for the week of Nov 11-15, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Tuesday Spoon Feed:In this randomized control trial of left versus right ultrasound-guided infraclavicular subclavian central venous access, the left-sided approach was associated with a lower catheter malposition rate.Friday Spoon Feed:The American Academy of Pediatrics has released their first clinical practice guideline on opioid prescribing in children and adolescents. The 12 evidence-based key action statements outline safe practices for prescribing opioids for acute pain in the outpatient setting.

The JournalFeed podcast for the week of Nov 4-8, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Wednesday Spoon Feed:This RCT found high-intensity non-invasive positive pressure ventilation (NPPV) in COPD patients with persistent hypercapnia decreased the need for endotracheal intubation according to prespecified criteria. Friday Spoon Feed:While there was concern for selection bias in a number of included studies, this systematic review and meta-analysis found that small–bore thoracostomy tubes may be appropriate to use in traumatic hemothorax.

The JournalFeed podcast for the week of Oct 28 – Nov 1, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Tuesday Spoon Feed:In this NEAR database study, there was an independent association between increasing number of intubation attempts and risk of complications.Wednesday Spoon Feed:Dual therapy with both ibuprofen and acetaminophen or in alternating regimens may be superior to monotherapy for treating fever in children. Ibuprofen also appears superior to acetaminophen at 4 hours when both are used as monotherapy but similar at 6 hours. 

The JournalFeed podcast for the week of Oct 21-25, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday Spoon Feed:This article emphasizes the difference between hypertensive emergency and asymptomatic elevated blood pressure (BP). While hypertensive emergency requires prompt treatment to lower BP, treatment of asymptomatic elevated BP in acute care settings may be harmful. Tuesday Spoon Feed: This was a multi-hospital retrospective study of patients who presented to the emergency department with severe hypertension without end organ damage. The authors found that the 1 year rate of major adverse cardiovascular events (MACE) was 15.5%.

The JournalFeed podcast for the week of Oct 14-18, 2024.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Wednesday Spoon Feed:This prospective study of a new proprietary rapid host-protein test, MeMed BV (MMBV), shows promising results for differentiating viral vs bacterial causes of fever. However, the gold standard for comparison was similar to current common practice, making it difficult to measure the added value of MMBV over usual care.Friday Spoon Feed: This large study in Canada of patients aged 66+ found that all commonly prescribed oral antibiotics were associated with an increased risk of serious cutaneous drug reactions (cADRs) relative to macrolides; however, few of these reactions led to hospitalization and an even smaller amount were true cutaneous emergencies (SJS/TEN).