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16

Sunshine Heart can resume trial after FDA OKs 'minor' changes – MassDevice

Sunshine Heart (NSDQ:SSH) said last week that the FDA will let it resume a clinical trial of its C-Pulse heart failure device once the safety watchdog approves "minor protocol changes."  
massdevice.com
over 6 years ago
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5

Open cardiac massage in asthmatic arrests? |

This idea was provoked by a colleague some years ago who could not achieve a palpable pulse during CPR of an arrested asthmatic child. He wondered whether the severe hyperinflation was rendering external cardiac compressions ineffective and whether he should have done a (prehospital) thoracotomy.  
resus.me
over 6 years ago
Sinaiem dark
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3839

5 y/o F presents to the ED feeling “uneasy.” She is noted to have a pulse of 140 and BP of 180/110 and is profusely sweating. She is on imipramine for bedwetting, no other PMH. Pupils are PERRL. Exam is otherwise unremarkable. CBC, BMP, UA are negative. When considering a toxidrome, what is your differential?  
sinaiem.org
over 6 years ago
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Fracture Fridays: Getting a leg up on the competition (Re-post)

An 80 pound 12 year old soccer star tripped in a hole while challenging for the ball. Another player on the pitch stumbled in the same (big) hole and landed awkwardly on the first player’s leg. Even the fans on the next field over heard the snap. EMS was called and an obviously uncomfortable 12 year old male with intact distal foot pulses and sensation presents to your ED. You do what you normally do and get an X-Ray.  
pemcincinnati.com
over 6 years ago
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19

Critical Care

Pulse oximetry is universally used for monitoring patients in the critical care setting. This article updates the review on pulse oximetry that was published in 1999 in Critical Care. A summary of the recently developed multiwavelength pulse oximeters and their ability in detecting dyshemoglobins is provided. The impact of the latest signal processing techniques and reflectance technology on improving the performance of pulse oximeters during motion artifact and low perfusion conditions is critically examined. Finally, data regarding the effect of pulse oximetry on patient outcome are discussed.  
ccforum.com
over 6 years ago
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40

Clinical Cases and Images: ClinicalCases.org: Prerenal Acute Renal Failure due to Volume Depletion

This is a good practical case and very useful for new clinicians. For any clinician:No foley catheter unless oliguric, anuric, obstructed since any catheter is a foreign body and increases infection risk.Rehydrate if U/A has high spec gavity, mucous membranes dry, or if BUN is >30 times the creatinine as in this case. Even CHF pts get dry if not in heart failure. If in doubt, do CXR, BNPT, listen for crackles.Start with 250cc IVF if BNPT not less than 150 or give carefully while checking lung bases posteriorly after each bolus along with pulse ox, etc as above. Half of pts in acute renal failure are septic. Look for and eliminate source such as pneumonia, foreign body, pyelonephritis, joint infections. May be afebrile/ low temp or low WBCs with sepsis. Do cultures, check lactate ASAP to detect sepsis BEFORE the BP drops. Lactic acid "the troponin of sepsis." If septic, give a lot of fluids (up to 10 liters often) since capillary leak syndrome will lead to severe hypotension. If septic expect edema to develop with IV boluses yet be aware pt is intravascularly depleted. No pressors without fluids "pressors are not your friend" as per lecturers on Surviving Sepsis campaign.  
clinicalcases.org
about 6 years ago
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15

Transcranial magnetic stimulation (TMS) for the treatment of schizophrenia | Cochrane

Transcranial magnetic stimulation is a relatively new and sophisticated device-based therapy. TMS involves the skilful application of a strong magnetic field close to the surface of the scalp. The TMS device delivers strong and very brief magnetic pulses that stimulate the brain and its network of neurons. TMS is a relatively painless and non-invasive technique that stimulates parts of the brain (the cerebral cortex). Brain activity has been shown to differ in people with schizophrenia compared to other people.  
cochrane.org
about 6 years ago
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FDA Clears Masimo MightySat Personal Pulse Oximeter with SET Measure-through Motion and Low Perfusion |

Masimo is releasing its MightySat pulse oximeter in the U.S. following FDA clearance of the device. It is designed for personal use but features Masimo's S  
medgadget.com
almost 6 years ago