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Sepsis Journal Club Roundup
The management of patients with sepsis can be exceptionally complex. As with many patient’s with complex critical illnesses, often times attention to seemingly minor aspects of the patient’s management can have significant impacts on the patient’s course of illness. In this recap of our most recent journal club, we review 3 such aspects of the care of patients with sepsis. Does the type of IV fluids really make a difference? Are steroids a friend or foe in the care of these patients? And can the simple bedside assessment of capillary refill replace serial measurements of lactate?
Controversies in Kidney Stones
Flank pain and pain due to ureterolithiasis are common ED presentations. There exist, however, a number of controversies when you dive into the literature addressing the diagnosis and treatment of nephrology/ureterolithiasis. Is IV lidocaine effective at treating pain in these patients? Is there a way to avoid CT scans? What about tamsulosin? Is it only good for big stones/small stones? Is there a benefit at all. For our most recent Journal Club, we tackled several of these controversies. Take a listen to the podcast below or over on iTunes.
Is the Cath Lab the Place to be after V fib VTac Cardiac Arrest?
Ventricular dysrhythmias are commonly caused by coronary ischemia which is most frequently caused by acute coronary artery occlusions in the setting of coronary artery disease. It would seem somewhat logical that patients who suffer a V fib or V Tach cardiac arrest would benefit from a trip to the cardiac catheterization lab to identify and treat these possible acute coronary artery occlusions. Patient’s with EKGs showing ST-elevations following ROSC already go to the Cath lab. Since the EKG is not terrifically sensitive for MI, should V fib V Tach cardiac arrest patients without ST-elevations make a trip to the Cath lab? In this breakdown of our most recent journal club we look at several papers covering this topic. In the podcast below we also talk with Justin Benoit, MD the site PI for the ongoing ACCESS trial which is also looking into this question.