I have written fairly extensively about the management of high risk PE. Despite their growing popularity, I have remained quite skeptical of catheter directed therapies. If you are going to give a thrombolytic, my sense is that it is going to be just as effective if given through a peripheral […]
ebm reviews Evidence Based Medicine
322 posts
Although guidelines have long suggested higher blood pressure targets in spinal cord injury, that recommendation has never been based on high quality evidence. (Walters 2013; Sanchez 2020) (This is the first ever RCT.) We have a bad habit of treating numbers in medicine, and often making things worse. (Remember the […]
At this point, most people in the emergency medicine and critical care worlds just assume that balanced (ie, 1:1:1) transfusion is a proven intervention, and the focus has mostly moved on the the potential of whole blood. I am in an almost nonexistent minority when I argue that balanced transfusion […]
Classic medicine: running high cost RCTs that are too small to give real answers Préterre C, Gaultier A, Obadia M, Vignal C, Mourand I, Plat J, Sablot D, Gaudron M, Rodier G, Godeneche G, Urbanczyk C, Marc G, Massardier E, Adam S, Boulanger M, Marcel S, Mechtouff L, Ronzière T, […]
The big paper of the month: ketamine vs etomidate for RSI Casey JD, Seitz KP, Driver BE, et al. Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults. N Engl J Med. 2025 Dec 9. doi: 10.1056/NEJMoa2511420. Epub ahead of print. PMID: 41369227 On its face, this is a […]
There are many different approaches to stable patients with atrial fibrillation who present to the emergency department. Personally, I have leaned towards electrical cardioversion over chemical cardioversion in patients in whom cardioversion is appropriate. In the places I work, it is usually faster and easier to get a patient sedated […]
Some topics just get people excited. The drugs we use during intubation – well, people are going to have an opinion. Etomidate was popular while I trained, but was actually hard to find in the emergency department. Then came worries of adrenal suppression. Was etomidate just changing biochemical outcomes, or […]
You are at a conference. You had 1 glass of wine too many last night, so you had to add an extra coffee to get moving this morning. Then you feel a slight flutter in your chest. Caffeine is a stimulant, right? Could it be causing atrial fibrillation? The paper […]