Hospital Medicine Alert – August 1, 2014
August 1, 2014
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Protocol-directed Care Does Not Lead to Improved Outcomes in Early Septic Shock
A large, multicenter clinical trial that compared protocol-based care to usual care for patients presenting to emergency departments with early sepsis and septic shock found no differences in clinical outcomes. However, early recognition and therapy was beneficial and should be the standard of care. -
Value of Electronic Surveillance for Hospital CAUTIs
Compared to manual surveillance methods, an electronic surveillance tool for catheter-associated urinary tract infections had a high negative predictive value but a low positive predictive value. -
Conservative Fluid Management Reduces the Incidence of VAP
Patients on mechanical ventilation who were managed with both conservative fluid administration and aggressive diuresis weaned faster, had significantly more ventilator-free days, and experienced reduced incidences of both ventilator-associated complications and ventilator-associated pneumonia. -
Predictors of Seizures After Trauma
In this large prospective study of trauma patients, the most important factor associated with post-traumatic seizures was the presence of alcohol intoxication. -
Get Thee to the Pharmacy! Delays in Clopidogrel After Coronary Stenting Can be Deadly
During my final year of interventional cardiology training, a woman in her 60s was brought emergently to the cath lab in cardiogenic shock, with diffuse ST-segment elevations.