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Emergency Medicine

Mass casualty medicine and anesthesia special issue: science and clinical practice.

26 Jan, 2022 | 02:04h | UTC

Editorials:

Mass casualty medicine: time for a 21st century refresh

Exercising for mass casualty preparedness

Massive transfusion and severe blood shortages: establishing and implementing predictors of futility

Transfusion support during mass casualty events

Embracing uncertainty in mass casualty incidents

Pre-hospital critical care at major incidents

Provision of pre-hospital medical care for terrorist attacks

Higher pre-hospital anaesthesia case volumes result in lower mortality rates: implications for mass casualty care

Improving mass casualty planning in low resource settings: Médecins Sans Frontières and International Committee of the Red Cross perspective

Global lessons learned from COVID-19 mass casualty incidents

Reimagining health preparedness in the aftermath of COVID-19

Preparing for mass casualty events despite COVID-19

Paediatric Anaesthesia:

Paediatric patients in mass casualty incidents: a comprehensive review and call to action

Adaptations to practice and resilience in a paediatric major trauma centre during a mass casualty incident

Pre-hospital Care:

Injury scoring systems for blast injuries: a narrative review

Association between case volume and mortality in pre-hospital anaesthesia management: a retrospective observational cohort

Establishing quality indicators for pre-hospital advanced airway management: a modified nominal group technique consensus process

Pre-hospital continuous positive airway pressure after blast lung injury and hypovolaemic shock: a modelling study

Preparedness:

Review of the requirements for effective mass casualty preparedness for trauma systems. A disaster waiting to happen?

Learning from terrorist mass casualty incidents: a global survey

Refining mass casualty plans with simulation-based iterative learning

Specific Incidents:

Mass casualty, intentional vehicular trauma and anaesthesia

Chemical, biological, radiological, and nuclear mass casualty medicine: a review of lessons from the Salisbury and Amesbury Novichok nerve agent incidents

Correspondence:

Pre-hospital oral transmucosal fentanyl citrate for trauma analgesia: preliminary experience and implications for civilian mass casualty response

Implications for trauma system development in a low- and middle-income country: the Sri Lanka 2019 Easter Sunday terrorist attack

Development and evaluation of a mass casualty medicine simulation method using figurines

Influx! A game-based learning tool for in-hospital interprofessional disaster preparedness and response

 


RCT: CPAP improved outcomes in patients with acute hypoxemic respiratory failure due to COVID-19, but high-flow nasal oxygen was not better than conventional oxygen therapy.

25 Jan, 2022 | 09:50h | UTC

Effect of Noninvasive Respiratory Strategies on Intubation or Mortality Among Patients With Acute Hypoxemic Respiratory Failure and COVID-19: The RECOVERY-RS Randomized Clinical Trial – JAMA

Editorial: Defining Optimal Respiratory Support for Patients With COVID-19 – JAMA

 

Commentary on Twitter

 


New CPR guidance addresses more contagious COVID-19 variants amidst evolving pandemic.

25 Jan, 2022 | 09:48h | UTC

News release: New CPR guidance addresses more contagious COVID-19 variants amidst evolving pandemic – American Heart Association

See Guidance: 2022 Interim Guidance to Healthcare Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates with Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With the Guidelines®-Resuscitation Adult and Pediatric Task Forces of the American Heart Association in Collaboration with the American Academy of Pediatrics, American Association for Respiratory Care, The Society of Critical Care Anesthesiologists, and American Society of Anesthesiologists

 


RCT: Fentanyl vs. placebo with ketamine and rocuronium for patients undergoing rapid sequence intubation in the emergency department.

25 Jan, 2022 | 09:14h | UTC

Fentanyl versus placebo with ketamine and rocuronium for patients undergoing rapid sequence intubation in the emergency department: the FAKT study – a randomized clinical trial – Academic Emergency Medicine (link to abstract – $ for full-text)

 


Updated Guideline: Recommended drugs and biologics in adult patients with COVID-19.

24 Jan, 2022 | 08:52h | UTC

Clinical Practice Guideline Summary: Recommended Drugs and Biologics in Adult Patients with COVID-19 – Covid-19 Advisory for Ontario

 

Commentary on Twitter (thread – click for more)

https://twitter.com/ASPphysician/status/1484874519252721664

 


A guide to immunotherapy for COVID-19.

24 Jan, 2022 | 08:29h | UTC

A guide to immunotherapy for COVID-19 – Nature Medicine

 


The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly.

24 Jan, 2022 | 08:24h | UTC

The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly – World Journal of Emergency Surgery

Related:

ACP Guideline: Diagnosis and management of acute left-sided colonic diverticulitis.

Review: Changing paradigms in the management of acute uncomplicated diverticulitis.

RCT: Another study shows that non-antibiotic outpatient treatment in mild acute diverticulitis is safe.

Review: Elective surgical management of diverticulitis

State of the Art Review | Management of colonic diverticulitis

Drains, germs, or steel: Multidisciplinary management of acute colonic diverticulitis

Diverticulitis: Observational study in outpatients suggests amoxicillin-clavulanate is a safe and effective option compared with metronidazole-fluoroquinolone

Randomized trial: Laparoscopic lavage vs. primary resection for perforated purulent diverticulitis; similar long-term results, but recurrence was more common after laparoscopic lavage

Randomized trial: In patients with recurrent, complicated, or persistent painful diverticulitis, sigmoid resection improved quality of life but was associated with a small but significant risk of major complications

Systematic review: Management of colonic diverticulitis

WSES Guidelines for the Management of Acute Colonic Diverticulitis

ASCRS Guidelines for the Treatment of Left-Sided Colonic Diverticulitis

 


Perioperative guidelines on antiplatelet and anticoagulant agents: 2022 Update.

21 Jan, 2022 | 09:53h | UTC

Perioperative Guidelines on Antiplatelet and Anticoagulant Agents: 2022 Update – Current Anesthesiology Reports

 


M-A: In comatose survivors of cardiac arrest, targeted hypothermia is not associated with improved survival or better neurological outcomes vs. targeted normothermia.

21 Jan, 2022 | 09:29h | UTC

Targeted Hypothermia Versus Targeted Normothermia In Survivors of Cardiac Arrest: A Systematic Review and Meta-Analysis of Randomized Trials – American Journal of Medicine

Related:

RCT: In comatose survivors of out-of-hospital cardiac arrest, there was no difference in mortality and neurologic outcomes with mild (target temperature of 34 °C) vs. moderate therapeutic hypothermia (target temperature of 31 °C).

M-A: Targeted temperature management following out-of-hospital cardiac arrest – “Routine use of moderate or deep hypothermia in comatose survivors of OHCA may potentially be associated with more harm than benefit”.

RCT: In patients with coma after out-of-hospital cardiac arrest, targeted hypothermia did not improve outcomes.

 


RCT: In non–critically ill hospitalized patients with COVID-19, the use of a P2Y12 Inhibitor (ticagrelor in 63% of patients and clopidogrel in 37%) in addition to a therapeutic dose of heparin did not improve survival free of organ support compared to therapeutic heparin alone.

19 Jan, 2022 | 08:56h | UTC

Effect of P2Y12 Inhibitors on Survival Free of Organ Support Among Non–Critically Ill Hospitalized Patients With COVID-19: A Randomized Clinical Trial – JAMA

Editorial: Antiplatelet Therapy in Patients With COVID-19—More Is Less? – JAMA

Commentary: Adding a P2Y12 Inhibitor Does Not Improve Outcomes in COVID-19 – HealthDay

 


RCT: In critically ill adults, using a balanced multielectrolyte solution did not lower the risk of death or acute kidney injury compared to standard saline.

19 Jan, 2022 | 08:41h | UTC

Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Australian study set to guide the treatment of critically ill patients worldwide – George Institute for Global Health

Related:

BaSICS RCT: Among critically ill patients requiring fluid therapy, treatment with a balanced solution did not lead to reduced mortality compared to a 0.9% saline solution.

BaSICS RCT: Among critically ill patients requiring fluid therapy, there was no difference in mortality with slower (333 mL/h) vs. faster (999 mL/h) intravenous fluid bolus rates.

Cochrane Review: Buffered Solutions Do Not Improve Mortality in Critically Ill Adults and Children Compared to 0,9% Saline

 

Commentary on Twitter

https://twitter.com/NEJM/status/1483540959518281730

 


M-A: Evaluation of interventions to reduce opioid prescribing for patients discharged from the emergency department.

19 Jan, 2022 | 08:13h | UTC

Evaluation of Interventions to Reduce Opioid Prescribing for Patients Discharged From the Emergency Department: A Systematic Review and Meta-analysis – JAMA Network Open

Invited commentary: Optimizing Opioid Prescriptions for Patients in the Emergency Department—How Much Is Almost Never? – JAMA Network Open

 

Commentary on Twitter

 


COVID-19 updated evidence: a Cochrane round-up.

18 Jan, 2022 | 09:53h | UTC

COVID-19 evidence: a Cochrane round-up – Cochrane Library

 


ACP Guideline: Diagnosis and management of acute left-sided colonic diverticulitis.

18 Jan, 2022 | 09:38h | UTC

Diagnosis and Management of Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians – Annals of Internal Medicine

Related Guideline: Colonoscopy for Diagnostic Evaluation and Interventions to Prevent Recurrence After Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians – Annals of Internal Medicine

Related Systematic Reviews:

Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

Evaluation and Management After Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

Annals Video Summary: Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

News Release: ACP releases two new clinical guidelines on the diagnosis and management of diverticulitis – American College of Physicians

 


WHO recommends two new drugs (Baricitinib and Sotrovimab) to treat COVID-19.

17 Jan, 2022 | 00:48h | UTC

News release: WHO recommends two new drugs to treat COVID-19 – World Health Organization

Infographic with the updated recommendations: A living WHO guideline on drugs for covid-19 – The BMJ

Commentaries:

WHO Recommends Two New COVID-19 Treatments – Cost and Availability Likely Barriers – Health Policy Watch

Expert reaction to WHO recommending two drugs, sotrovimab and baricitinib, to treat patients with COVID-19 – Science Media Centre

 

Commentary on Twitter (thread – click for more)

 


Viewpoint: COVID-19 therapeutics for nonhospitalized patients.

17 Jan, 2022 | 00:31h | UTC

COVID-19 Therapeutics for Nonhospitalized Patients – JAMA

Editorial: Realizing the Potential of Anti–SARS-CoV-2 Monoclonal Antibodies for COVID-19 Management – JAMA

 


Multi-Disciplinary Guideline: Management of nephrolithiasis in pregnancy.

16 Jan, 2022 | 23:17h | UTC

Management of Nephrolithiasis in Pregnancy: Multi-Disciplinary Guidelines From an Academic Medical Center – Frontiers in Surgery

 

Commentary from the author on Twitter

 


RCT: In patients undergoing emergency endotracheal intubation, 7-day survival was significantly lower with etomidate vs. ketamine (77.3% versus 85.1%), but 28 survival rates were not significantly different (etomidate 64.1% vs. ketamine 66.8%, p = 0.294).

16 Jan, 2022 | 23:09h | UTC

Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial – Intensive Care Medicine

Commentary: SGEM#356: Drugs are gonna knock you out – etomidate vs. ketamine for emergency endotracheal intubation – The Skeptics’ Guide to EM

 

Commentary on Twitter

 


Fluvoxamine for Covid-19: What Prescribers and Pharmacists Need to Know.

14 Jan, 2022 | 08:37h | UTC

Fluvoxamine: What Prescribers and Pharmacists Need to Know – Covid-19 Advisory for Ontario

Related:

Fluvoxamine for the early treatment of SARS-CoV-2 Infection: a review of current evidence.

RCT: Early treatment with fluvoxamine reduced the risk of emergency care and hospitalization among patients with COVID-19.

[Preprint] RCT: Fluvoxamine reduced the risk for ER visits and hospitalization among patients with Covid-19.

Opinion | Could this be our first effective, inexpensive, widely available outpatient treatment for COVID-19? (It’s fluvoxamine).

Preliminary study shows fluvoxamine may reduce clinical deterioration in outpatients with symptomatic COVID-19

 

Commentary on Twitter

 


AAN Position Statement: Consent Issues in the Management of Acute Ischemic Stroke.

14 Jan, 2022 | 08:24h | UTC

Consent Issues in the Management of Acute Ischemic Stroke: AAN Position Statement – Neurology

News Release: Who gives consent for treatment when a person with stroke cannot? – American Academy of Neurology

 


Systematic Review: Restrictive transfusion thresholds can safely decrease transfusions by 41% across a broad range of clinical contexts.

14 Jan, 2022 | 08:18h | UTC

Transfusion thresholds for guiding red blood cell transfusion – Cochrane Library

Summary: Is it safe to use lower blood counts (haemoglobin levels) as a trigger for blood transfusion in order to give fewer blood transfusions? – Cochrane Library

Related:

RCT: Among patients with acute MI and anemia, a restrictive transfusion strategy resulted in a noninferior rate of major cardiovascular events compared to a liberal transfusion strategy

Randomized trial: Liberal vs. restrictive transfusion thresholds in extremely low-birth-weight infants

Meta-Analysis: Effects of Restrictive vs. Liberal Transfusion Strategies on Longer-term Outcomes After Cardiac Surgery

Randomized Trial: In Patients Undergoing Cardiac Surgery, A Restrictive Transfusion Approach Does Not Increase the Risk of Acute Kidney Injury

Effects of restrictive red blood cell transfusion on the prognoses of adult patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials – Critical Care

Research: Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery

Transfusion Requirements After Cardiac Surgery: The TRACS Randomized Controlled Trial – JAMA

 

Commentary on Twitter

https://twitter.com/cochraneINJ/status/1473667822542888964

 


RCT: Early Remdesivir in outpatients can prevent progression to severe Covid-19.

13 Jan, 2022 | 08:54h | UTC

Early Remdesivir to Prevent Progression to Severe Covid-19 in Outpatients – New England Journal of Medicine

Editorial: The Goldilocks Time for Remdesivir — Is Any Indication Just Right?

Commentary: Three days of remdesivir cuts risk for severe COVID-19 in outpatients – MedicalXpress

 

Commentary on Twitter

 


Another study showed neutralizing monoclonal antibody therapies are not effective when given after the patient is already hospitalized.

13 Jan, 2022 | 08:48h | UTC

Efficacy and safety of two neutralising monoclonal antibody therapies, sotrovimab and BRII-196 plus BRII-198, for adults hospitalised with COVID-19 (TICO): a randomised controlled trial – The Lancet Infectious Diseases

Invited Commentary: Time to knock monoclonal antibodies off the platform for patients hospitalised with COVID-19

 


Cohort Study: Patient factors associated with appendectomy within 30 days of initiating antibiotic treatment for appendicitis – the presence of an appendicolith was associated with a nearly 2-fold increased risk of undergoing appendectomy within 30 days.

13 Jan, 2022 | 08:39h | UTC

Patient Factors Associated With Appendectomy Within 30 Days of Initiating Antibiotic Treatment for Appendicitis – JAMA Surgery (free for a limited period)

Invited commentary: Appendicoliths, Antibiotic Treatment Failure, and Appendectomy—Is the Glass Half Full or Half Empty? – JAMA Surgery

 


The COVID-19 Treatment Guidelines Panel’s Statement on Anticoagulation in Hospitalized Patients With COVID-19 – in the absence of contraindications, use therapeutic-dose anticoagulation with low molecular weight heparin for hospitalized patients not in the ICU who have a D-dimer above the upper limit of normal.

12 Jan, 2022 | 09:11h | UTC

The COVID-19 Treatment Guidelines Panel’s Statement on Anticoagulation in Hospitalized Patients With COVID-19 – NIH COVID-19 Treatment Guidelines

 


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