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EGDT IS DEAD, LONG LIVE EGDT

And so the EGDT trilogy is complete. The results of the ProMISe trial was published, after we’ve recently had the results from the ARISE and ProCESS trials. They all compared EGDT (Early Goal-Directed Therapy) to “standard care”. And they were all agreeing: Standard care is as good as EGDT. But who has practices orthodox EGDT this last decade? Not anyone I’ve spoken to. And what is “standard care” – it’s mostly a tweaked version of EGDT. So as far as we’re concerned, not much new here, and the legacy of EGDT is still very much alive and kicking.  
scancrit.com
about 4 years ago
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SGEM#100: Why Can’ t This Be Love? Early Goal Directed Dating (EGDD)

Guest Skeptics: Dr. Chris Bond. Chris is a clinical lecturer and emergency physician at the University of Calgary, creator of the SOCMOB blog, dogma basher, and wine/food super geek. Chris appeared on SGEM#86 (Achy Breaky Heart) discussing colchicine as a very effective treatment for acute pericarditis.  
thesgem.com
about 4 years ago
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SGEM Elevator Pitch with Disclaimer

My name is Ken Milne. The goal of the SGEM is to cut the knowledge translation window from 10 years down to 1 year. It does this by using social media to provide you with high quality, clinically relevant, critically appraised, evidence based information.  
thesgem.com
about 4 years ago
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SGEM#69: Cry Me A River (Early Goal Directed Therapy) ProCESS Trial

Case Scenario: You are working in a rural community emergency department. The next patient you see is a 71 year old man who has been sick for three days with fever, chills and a productive cough.  On arrival, the vital signs were as follows: Temp 38.7C, HR 110, RR 24, BP 95/60 (after a 500cc normal saline bolus by ambulance), oxygen saturations 88% on room air.  Skin looks mottled, and the patient seems to be confused on questioning.  
thesgem.com
about 4 years ago
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Dr. Richard A. Memo talks about the goals and efforts of the Urology Care Foundation.

Dr. Richard A. Memo, Chair of the Urology Care Foundation, talks about the goals and efforts of the Urology Care Foundation.  
youtube.com
about 4 years ago
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Dr. Richard A. Memo talks about the goals and efforts of the Urology Care Foundation. - YouTube

Dr. Richard A. Memo, Chair of the Urology Care Foundation, talks about the goals and efforts of the Urology Care Foundation.  
youtube.com
about 4 years ago
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WHO | World Health Statistics reports on global health goals for 194 countries

13 May 2015 | GENEVA - 2015 is the final year for the United Nations Millennium Development Goals (MDGs) – goals set by governments in 2000 to guide global efforts to end poverty. This year’s "World Health Statistics" – published today by WHO – assesses progress towards the health-related goals in each of the 194 countries for which data are available. The results are mixed.  
who.int
about 4 years ago
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Textbook of Post-ICU Medicine

Surviving critical illness is not always the happy ending that we imagine for patients. Intensive care unit (ICU) teams have traditionally focused on short term goals such as stabilizing or reversing organ system dysfunction, with little understanding of what became of patients once they left the ICU. However, research conducted in recent years has demonstrated that many ICU survivors can suffer from ill health and mental health issues for months or years to follow. The Textbook of Post-ICU Medicine: The Legacy of Critical Care identifies the long term outcomes of ICU and the steps that can be taken to improve patients' health and wellbeing. Describing the major clinical syndromes affecting ICU survivors, the book delineates established or postulated biological mechanisms of the post-acute recovery process, and discusses strategies for treatment and rehabilitation to promote recovery in the ICU and in the long term. Many ICU survivors suffer from a range of long-lasting physical and psychological issues such as end stage renal disease, congestive heart failure, cognitive impairment, neuromuscular weakness, and depression or anxiety, which affect their overall quality of life and ability to lead productive lives. This book discusses the science of the recovery process and the innovative treatment regimens which are helping ICU survivors regain function as they heal following trauma or disease. This lingering burden or 'legacy' of critical illness is now recognized as a major public health issue, with major efforts underway to understand how it can be prevented, mitigated, or treated. The chapters are written by an interdisciplinary panel of leading clinicians and researchers working in the field. The book serves as a unique reference for general practitioners, internists and nurses caring for long term ICU survivors as well as specialists in intensive care medicine, neurology, psychiatry, and rehabilitation medicine.  
books.google.co.uk
about 4 years ago
Www.bmj
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India makes strides in some, but not all, health goals, finds WHO

India has successfully met targets to reduce the spread of HIV and improve the availability of drinking water but has a long way to go in improving sanitation facilities and providing universal access to reproductive healthcare, the latest World Health Statistics report has found.  
feeds.bmj.com
about 4 years ago
Www.bmj
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India makes strides in some, but not all, health goals, finds WHO

India has successfully met targets to reduce the spread of HIV and improve the availability of drinking water but has a long way to go in improving sanitation facilities and providing universal access to reproductive healthcare, the latest World Health Statistics report has found.  
feeds.bmj.com
about 4 years ago
Www.bmj
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India is declared free of maternal and neonatal tetanus

India has reached its goal of eliminating maternal and neonatal tetanus, in what experts have heralded as a “significant public health milestone.” The elimination of neonatal tetanus is defined as less than one case in 1000 live births in every district across the country, said the World Health Organization.  
feeds.bmj.com
about 4 years ago
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What can #meded learn from sepsis management?

By Damian Roland  The last of the trilogy of Early Goal Directed Therapy (EGDT) for sepsis management studies was published recently. The results, on the face of it, appeared surprising. There is no difference in outcome when either an algorithmic-based protocol or clinical gesalt is used in the management of patients with septic shock. The…  
icenetblog.royalcollege.ca
about 4 years ago
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Art of Medicine Video: Discussing Mild to Moderate Croup with Parents in the Emergency Department

This is the first video in the ongoing Art of Medicine series common . The goal is these videos is to share a demonstration of how I would talk to parents about common conditions encountered in the Emergency Department. I could think of no better topic than mild to moderate croup without stridor at erst. In less than 4 minutes you can review:  
pemcincinnati.com
about 4 years ago
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Critical Care

Goal-directed therapy (GDT) has been shown in numerous studies to decrease perioperative morbidity and mortality. The mechanism of benefit of GDT, however, has not been clearly elucidated. Targeted resuscitation of the vascular endothelium with GDT might alter the postoperative inflammatory response and be responsible for the decreased complications with this therapy.  
ccforum.com
about 4 years ago
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Holographic Microscopy Identifies Single Bacterium at Point of Care |

Rapid point of care identification of bacterial infections remains an elusive goal in many instances, with labs around the world relying on culturing that  
medgadget.com
about 4 years ago
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Social skills programmes for people with schizophrenia | Cochrane

Social skills programmes (SSP) use behavioural therapy and techniques for teaching individuals to communicate their emotions and requests. This means they are more likely to achieve their goals, meet their needs for relationships and for independent living as well as getting on with other people and socially adjusting. Social skills programmes involve 'model learning' (role playing) which was introduced to improve general 'molecular' skills (eye contact, fluency of speech, gestures) and 'molar' skills (managing negative emotions, giving positive feedback). Social skills programmes enhance social performance and reduce the distress and difficulty experienced by people with schizophrenia. Social skills programmes can be incorporated as part of a rehabilitation package for people with schizophrenia.  
cochrane.org
about 4 years ago
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SGEM#125: I’m So Excited

The goal of the Skeptics’ Guide to Emergency Medicine (SGEM) is to shorten the knowledge translation window from over ten years down to less than one year. It accomplishes this by doing a critical appraisal of a recently published article using the Best Evidence in Emergency Medicine (BEEM) process. BEEM has the only validated audience rating tool in emergency medicine and to the best of my knowledge, the only known measure of clinical relevance.  
thesgem.com
about 4 years ago
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Critical Care

Perioperative goal-directed therapy (PGDT) may improve postoperative outcome in high-risk surgery patients but its adoption has been slow. In 2012, we initiated a performance improvement (PI) project focusing on the implementation of PGDT during high-risk abdominal surgeries. The objective of the present study was to evaluate the effectiveness of this intervention.  
ccforum.com
about 4 years ago
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A Chip That Mimics Human Organs Is the Design of the Year

The chip's ultimate goal is to lessen dependence on animal test subjects and decrease time and cost for developing drugs.   
wired.com
about 4 years ago
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WHO | Lack of sanitation for 2.4 billion people is undermining health improvements

Lack of progress on sanitation threatens to undermine the child survival and health benefits from gains in access to safe drinking water, warn WHO and UNICEF in a report tracking access to drinking water and sanitation against the Millennium Development Goals.  
who.int
about 4 years ago