Critical Care

Advanced Practice: Subcutaneous insulin for DKA!

You are treating a patient for diabetic ketoacidosis in the ED. Thing is, the patient isn't very ill and only has mild DKA (pH 7.25-7.3). Is starting a continuous insulin infusion and admitting the patient to an intensive care unit bed really the best use of resources? Read on for an alternative suggested regimen using subcutanoues doses of rapid acting insulin

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Advanced Practice - Practice Changing Landmark Peds DKA Study!

For decades now, aggressive fluid replacement in pediatric DKA patients has been thought to contribute to cerebral edema and neurologic injury. This has resulted in a general policy of cautious fluid replacement with isotonic crystalloid, and perhaps even contributed to under-resuscitation of these patients. In this first large, randomized, prospective study to examine the role of type of fluid (0.9% NaCl vs 0.45% NaCl) and rate of administration, the hope was to detemine if type of fluid, rate of adminstration, or both were associated with cerebral edema and neurologic injury in this patient population. Read on for the key results of this practice changing paper!

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Advanced Practice - New Sepsis Guidelines Ignite Controversy!

The Surviving Sepsis Campaign has published a 2018 update to their guidelines for sepsis care. The new recommendations have sparked major controversy in the emergency medicine, critical care, and infectious disease communities. Read on for a brief summary of the most controversial points and links to further reading!

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Advanced Practice: Airway Mastery Series! DL vs VL for Airway Management in the ED

The ResusEM conference is coming back this August! This is a summary of a portion of Dr. Byrne's talk on airway management presented at the August 2017 ResusEM conference at Cooper Medical School of Rowan University. Check out some of the literature looking at the performance of video largyngoscopy versus direct laryngoscopy in various hospital settings.

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