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急診筆記: 【新藥】Dabigatran有可能取代warfarin？！

http://er119test.blogspot.com/2009/12/dabigatranwarfarin.html

12304;新藥】Dabigatran有可能取代warfarin？！ Oral Alternative to Warfarin for Venous Thromboembolism? Dabigatran was safe and effective and had advantages over warfarin. Is a direct oral thrombin inhibitor. That, unlike warfarin,. Can be given in a fixed dose and requires no laboratory monitoring. In a recently published study, dabigatran compared favorably with warfarin in patients with atrial fibrillation (JW Cardiol Sep 1 2009). Allan S. Brett, MD. Published in Journal Watch General Medicine December 8, 2009.

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急診筆記: 十月 2010

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Hemodialysis vs. Peritoneal Dialysis. Outcomes are comparable, but few patients chose peritoneal dialysis. Patients with end-stage renal disease (ESRD) have better outcomes with kidney transplant than with dialysis. However, about 100,000 ESRD patients start dialysis annually because of limited donor organs or contraindications to transplantation; about 7% start with peritoneal dialysis (PD). In two U.S. studies, researchers address outcomes of and preferences for PD and hemodialysis (HD). Kutner NG et a...

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急診筆記: 外傷急救新觀念：術中血壓不必keep太高！

http://er119test.blogspot.com/2011/05/keep.html

Hypotensive Resuscitation in Trauma Patients Lessens Transfusion Needs. Also reduces incidence of postoperative coagulopathy and associated death. Or 65 mm Hg (high MAP). Methods of achieving target levels were at the discretion of the anesthesiologist. MAPs that rose above the target were not lowered. If these promising findings hold in the final analysis, similar approaches should be undertaken in the field and the emergency department. John A. Marx, MD, FAAEM. 訂閱： 張貼留言 (Atom).

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急診筆記: 四月 2011

http://er119test.blogspot.com/2011_04_01_archive.html

Norepinephrine Outperforms Dopamine in Adults with Septic Shock. Use of norepinephrine was associated with a 9% reduction in mortality. The trials included a total of 995 patients randomized to norepinephrine and 1048 randomized to dopamine. Overall, mortality was significantly lower in the norepinephrine group than in the dopamine group (48% vs. 53%). Arrhythmias were significantly less common with norepinephrine than with dopamine (relative risk, 0.43). Kristi L. Koenig, MD, FACEP. Http:/ dx.doi&#4...

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急診筆記: 十一月 2010

http://er119test.blogspot.com/2010_11_01_archive.html

Clinical variables fail to predict pediatric ketamine-associated laryngospasm. In a 2009 meta-analysis of 8282 children undergoing ketamine sedation in the emergency department, investigators identified risk factors for airway and respiratory adverse events, including 22 occurrences (0.3%) of laryngospasm, defined as "stridor or other evidence of airway obstruction that did not improve with airway alignment maneuvers" (Ann Emerg Med 2009; 54:158). Now, the investigators performed a case-control a...Publi...

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急診筆記: 三月 2011

http://er119test.blogspot.com/2011_03_01_archive.html

Highly Sensitive ED Protocol for Identifying Low-Risk Patients with Chest Pain. Implementation of a new accelerated diagnostic protocol could reduce emergency department length of stay and hospitalization rate. The protocol included Thrombolysis In Myocardial Infarction (TIMI) score, electrocardiogram (ECG), and point-of-care biomarker testing (within 2 hours after arrival) for troponin I, creatine kinase MB, and myoglobin. Patients with TIMI scores of 0. No new ischemic changes on initial ECG. This nove...

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急診筆記: 一月 2011

http://er119test.blogspot.com/2011_01_01_archive.html

高壓氧治療CO中毒，效果沒想像中好？！ Is Hyperbaric Oxygen Therapy Beneficial in Carbon Monoxide Poisoning? HBO therapy did not add benefit to normobaric oxygen therapy in these studies. In two parallel prospective randomized studies, researchers evaluated the effectiveness of hyperbaric oxygen therapy (HBOT) in patients (age, ≥15 years) with acute isolated carbon monoxide (CO) poisoning who presented to an academic hospital in France between 1989 and 2000. In trial A (mild poisoning), 179 patients. Pending a larger trial...

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急診筆記: 六月 2010

http://er119test.blogspot.com/2010_06_01_archive.html

Alarming Rise in Major Complications from Button Battery Ingestions. Ingestion of large button batteries, particularly lithium cells, accounts for the increase in poor outcomes. These data are sobering. Physicians should keep button cells high on the list of differential diagnoses for any child who presents with airway obstruction or wheezing, drooling, vomiting, chest discomfort, difficulty swallowing or refusal to eat, or choking or coughing while eating or drinking. Katherine Bakes, MD. Patients admit...

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急診筆記: 七月 2010

http://er119test.blogspot.com/2010_07_01_archive.html

Cricoid Pressure During Intubation of Trauma Patients: Helpful or Harmful? Release of cricoid pressure improved the laryngoscopic view in 11 of 22 patients. John A. Marx, MD, FAAEM. Published in Journal Watch Emergency Medicine July 23, 2010. CITATION(S): Harris T et al. Cricoid pressure and laryngeal manipulation in 402 pre-hospital emergency anaesthetics: Essential safety measure or a hindrance to rapid safe intubation? Resuscitation 2010 Jul; 81:810. No benefit for lowering BP to below 130/80 mm Hg.