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Ninety percent of 585 of board-certified healthcare chaplains said advance care planning is important to their work, 70% regularly help patients complete paperwork after discussions, 90% facilitate discussions with patients about their preferences, and 45% reported they were not consistently included in team discussions on decision-making.
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Drugs of abuse are commonly encountered in the trauma setting. Patient care may be affected by acute intoxication and chronic use of these substances. Central nervous system depressants can result in coma and respiratory depression in severe toxicity. The authors discuss common presentations, potential complications, and management of central nervous system depressants in the context of a trauma patient.
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The MENDS2 trial found that dexmedetomidine, when used for light sedation, had outcomes similar to those for propofol.
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These two trials had disparate findings with respect to interleukin-6 inhibition, with REMAP-CAP showing a benefit and COVACTA showing none.
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In this retrospective analysis of COVID-19 patients hospitalized with cytokine storm, the use of corticosteroids combined with tocilizumab was associated with superior survival when compared to no immunomodulatory treatment; a combination of corticosteroids and anakinra; or corticosteroids, tocilizumab, or anakinra alone. Patients who received corticosteroids, either alone or in combination with anakinra, also experienced lower hospital mortality compared to no treatment.
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Some ethicists are unaware of how code status options are named and defined at their institutions. Researchers found that at some hospitals, code status options in the electronic medical record did not even match what was in the hospital policy. Ethics should be one of the experts in this area.
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Right after the FDA issued an emergency use authorization for one drug, feds pressed pause on distributing another.
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By shortening the duration of antibiotic therapy, a procalcitonin-guided protocol decreased the rate of infection-associated adverse effects, decreased costs, and reduced mortality in patients with sepsis.
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The WHO Solidarity Trial Consortium found remdesivir, hydroxychloroquine, lopinavir, and interferon regimens produced “little or no effect” on relevant outcomes.
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Optimizing positive end-expiratory pressure to minimize driving pressure may be a better strategy for ventilator adjustment than maximizing partial pressure of arterial oxygen/fraction of inspired oxygen (P/F) ratios to improve outcomes in patients with acute respiratory distress syndrome.
