Rap 91

1) IVC Ultrasound for Fluid Assessment

Review Summary

  • Source: EMRAP
  • Authors: Anand Swaminathan, MD, Haney Mallemat, MD
  • Reviewer: Jordan Richardson, MD
3
/ 7
BEEM Rater Scale
5
/ 7
Educational Utility
4
/ 7
Evidence Based Medicine

Takeaway

There is poor evidence for the validity of IVC as a marker of volume status, and it should be considered in conjunction with other findings.

2) BP Target in Spinal Cord Injury

Review Summary

  • Source: First10EM
  • Author: Justin Morgenstern, MD
  • Reviewer: Maximilian Redemann, MD
5
/ 7
BEEM Rater Scale
5
/ 7
Educational Utility
3
/ 7
Evidence Based Medicine

Takeaway

Conservative blood pressure goals may not have a significant difference in mortality and
neurological outcomes when compared to augmented blood pressure goals (higher MAP), and may even
be more appropriate when trying to limit clinical complications.

3) Further Disambiguating PEA

Review Summary

  • Source: EMCrit
  • Author: Scott Weingart, MD
  • Reviewer: Brianna Wenande, MD
4
/ 7
BEEM Rater Scale
5
/ 7
Educational Utility
5
/ 7
Evidence Based Medicine

Takeaway

Manual pulse checks are not accurate at detecting a pulse or perfusion during codes. Doppler US measurement is a promising alternative if feasible.

4) Philosophy of Arterial Lines in the ED

Review Summary

  • Source: EMCrit
  • Author: Scott Weingart, MD
  • Reviewer: Kurt Isenberger, MD
5
/ 7
BEEM Rater Scale
5
/ 7
Educational Utility
4
/ 7
Evidence Based Medicine

Takeaway

Arterial lines should be placed early in selected critically ill ED patients. Placement should be based on the patient’s physiology—not whether the patient is physically located in the ED or ICU.