International Journal of

Critical Care and Emergency MedicineISSN: 2474-3674


 Open Access DOI:10.23937/2474-3674/1510069

Preparing Residents for Emergent Vascular Access: The Comparative Effectiveness of Central Venous and Intraosseous Catheter Simulation-Based Training

Kristin Schwab, MD, Jodi Friedman, MD, Michael E Lazarus, MD and Jason P Williams, MD

Article Type: Brief Report | First Published: February 16, 2019

Resident physicians are often required to perform central venous catheter (CVC) or intraosseous catheter (IO) placement when supervision is not readily available. We assessed whether brief CVC and IO simulation-based training increases resident knowledge and comfort performing these procedures unsupervised. Residents were assigned to either a 60-minute CVC training or a control group that received no training; they were also assigned to either a 30-minute IO training or a control group. Both tra...

 Open Access DOI:10.23937/2474-3674/1510068

What Statistics do Emergency Physicians Need to Know

Edward A Ramoska, MD, MPH*, Virat Patel, MD, Alin Gragossian, DO and Romy Nocera, PhD

Article Type: Original Article | First Published: February 14, 2019

We evaluated 545 articles. Almost 60% of them were cohort studies; 17% were randomized controlled trials, 15% were cross-sectional studies and 4% were meta-analyses. The mean number of statistical tests per article was 4.16 (SD = 1.98), with a median of 4 (IQR = 2). The top ten statistical techniques applied (descriptive statistics, confidence intervals, contingency tables, t-tests, epidemiologic statistics, non-parametric tests, regression analysis, power analysis, multiway tables, and non-para...

 Open Access DOI:10.23937/2474-3674/1510067

Use of Programmed Multilevel Ventilation as a Superior Method for Lung Recruitment in Heart Surgery

Peter Candik, Adrian Kolesar, Martin Nosal, Matus Pauliny, Frantisek Sabol, Viera Donicova, Viliam Donic and Pavol Torok

Article Type: Original Article | First Published: January 26, 2019

During cardiac surgery, extracorporeal circulation (ECC) causes lung injury. In these inhomogenously affected lungs, the pressure control ventilation (PCV) cannot adequately ventilate differently damaged lung compartments. We invented and used original multilevel lung ventilation method named 3-LV based on alternating 3 or more pressure levels, ventilation frequencies and delivered tidal volumes. The goal of this article is to compare lung mechanics in cardiac surgery patient after ECC using sta...

 Open Access DOI:10.23937/2474-3674/1510066

Altruism: Brief Review of Current Opinions and Implications on Community Emergency Medicine

Oshionwu EJ and Nwose EU

Article Type: Commentary | First Published: January 25, 2019

There are several theories on altruism including the concept of pseudo-altruism. The latter constitute divergent opinion around egoism and socioeconomic status (SES). Review has identified that the conflict between altruistic and pseudo-altruistic theoretical approaches can be resolved by combining elements from both concepts. The objective of this commentary is to advance (1) That there is 'benefit to the helping altruistic individual in all altruism theories; and (2) A unifying viewpoint in te...

 Open Access DOI:10.23937/2474-3674/1510065

Predictors of Adverse Outcome Early After ICU Discharge

Katsiari M, Ntorlis K, Mathas C and Nikolaou C

Article Type: Original Article | First Published: January 07, 2018

Clinicians are often confronted with the timely discharge decision, in order to avoid readmission and escalation of costs. Aim of the present study was to determine potential risk factors for ICU readmission or death early after ICU discharge. The Intensive Care Unit (ICU) is the designated department in the hospital for the care of the most unstable and sickest patients. Depending on ICU availability, it is possible these intubated and critically ill patients are being hospitalized in other are...

 Open Access DOI:10.23937/2474-3674/1510064

Extreme Hypernatraemia and Sepsis in a Patient with Huntington's Dementia: A Conundrum in Fluid Management

Harish Venkatesh, Sanjeev Ramachandran, Atanu Basu and Hari Nair

Article Type: Case Report | First Published: January 05, 2019

We report a unique case of extreme hypernatraemia of 196 mmol/L and severe sepsis in a young 39-year-old adult with Huntington's dementia, which presented a challenge in fluid management. The hypernatraemia was thought to be caused by chronic severe dehydration from poor intake and the sepsis was thought to have started as an inadequately treated urinary tract infection. The patient was initially treated aggressively with hypotonic saline and intravenous antibiotics but was subsequently managed ...

 Open Access DOI:10.23937/2474-3674/1510063

An Exploratory Study of Overnight Education in the Medical Intensive Care Unit

Camille R Petri, Brittany L Ranchoff, Amy P Cohen, Amy M Sullivan, Richard M Schwartzstein and Margaret M Hayes

Article Type: Brief Report | First Published: January 04, 2019

Many hospitals in the United States employ overnight intensivist coverage for their medical intensive care units, but little is known about the effect of this staffing model on trainee education, and the learning that occurs overnight. This study examined the educational interactions occurring between residents and overnight intensivists in the context of the overnight multidisciplinary learning environment....

 Open Access DOI:10.23937/2474-3674/1510062

Is it Always Necessary to Take Blood Cultures before Starting Antibiotics in the Emergency Department? A Review of Usefulness of Blood Cultures in Community-Acquired Pneumonia, Cellulitis, Urinary Tract Infection and Pyelonephritis

Koh Nan Jun, Quek Hui Yu and Lateef F

Article Type: Review Article | First Published: January 03, 2019

Routine blood cultures are commonly taken in patients who present to the Emergency Department (ED) with suspicion of infection. This is also in conjunction with treatment guidelines for severe community-acquired pneumonia, acute meningitis and bacteraemia, etc. The above practice has become a major area of resource utilisation, despite many studies showing poor yield of these cultures. The poor yield of blood cultures is financially costly for patients, and even more so for hospitals. Hidden cos...

 Open Access DOI:10.23937/2474-3674/1510061

Efficacy of Cervical Immobilization in Multiple Trauma Patients

S Cacho Garcia, D Pena Otero and M Eguillor Mutiloa

Article Type: Review Article | First Published: January 03, 2019

Immobilization is one of the most used procedures to prevent spinal cord injury in multiple trauma patients in prehospital setting. However, its protocolary use has historical principles rather than a scientific origin. Although this technique restricts the movement of the injured spine, there is no evidence supporting its use in all patients suffering from trauma. The concept of multiple trauma includes all those patients who have traumatic injuries that affect at least two or more organs (or m...

Volume 5
Issue 1