Conservative vs Interventional Management of Spontaneous Primary Pneumothoracies (PSP)

What No COVID? Then at Least Lets Talk Steroids- in ARDS that is…

Reference: Villar. Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial. Lancet Respir Med 2020; 8: 267–76. I know what you are thinking, “What gives? No COVID!” Well the two of you who read this are probably inundated with COVID info. So to give our brains a change I thought I would […]

How much FIO2 do you get from that non-rebreather (NRB) mask? (aka There’s a hole in breather, dear Liza, a hole)

THE BOTTOM LINE A non-rebreather (NRB) mask ONLY delivers high FIO2 when the flow meter valve is opened fully and even then only gets to about 90%. THE DETAILS I find great joy in reading old literature. I’m pretty sure I would be camped out in a medical library if it weren’t for the interwebs, […]

Macrolide Resistance: Is Resistance Futile?

There hasn’t been an update to the IDSA/ATS guidelines for CAP (community acquired pneumonia) since 2007 (I keep hearing they will be out soon). These guidelines recommend  a macrolide antibiotic as first-line therapy for previously healthy patients who have no risk factors for drug-resistant S. pneumonia (SPN) infection (strong recommendation) and a combination of a […]

QUICK HIT #11: WHAT TIDAL VOLUME SHOULD BE STARTED IN PATIENTS WITHOUT ARDS

QUICK HIT ARTICLE Effect of a Low vs. Intermediate Tidal Volume Strategy on Ventilator-Free Days in Intensive Care Unit Patients Without ARDS: A Randomized Clinical Trial. Writing Group for the PReVENT Investigators . Simonis. JAMA. 2018; 320(18):1872-1880 All right pop quiz, hotshot. Altered patient gets intubated in the ED. He’s almost to the ICU. The RT asks […]

QUICK HIT ARTICLE #2: Hi Flo!

The Article: Doshi. P. High-Velocity Nasal Insufflation in the Treatment of Respiratory Failure: A Randomized Clinical Trial. Ann Emerg Med. 2018;72:73-83. To be or not to be, chocolate or vanilla, Bipap or High Flow… That is the question. In respiratory failure which modality is best for the distressed patient to prevent intubation. I’ve always […]