Cadaveric emergency cricothyrotomy training for non-surgeons using a bronchoscopy-enhanced curriculum.

Background: Emergency cricothyrotomy training for non-surgeons is important as rare "cannot intubate or oxygenate events" may occur multiple times in a provider's career when surgical expertise is not immediately available. However, such training is highly variable and often infrequent, therefore, enhancing these experiences is important.

Research Question: Is bronchoscopy-enhanced cricothyrotomy training in cadavers feasible, and what are the potential benefits provided by this innovation for trainees?

Methods: This study was performed during implementation of a new program to train non-surgeon providers on cadaveric donors on our campus.

Destination Critical Care: A Roadmap for Academic Clinicians, Educators, and Mentors.

The purpose of this article is to provide a framework for academic clinicians, educators, and mentors to advise the emergency medicine (EM) resident with an interest in the field of critical care medicine. Prior articles have detailed the prerequisites and specific training curricula of the distinct critical care pathways, but an approach for the advising faculty member in this climate of increased interest in critical care training has yet to be disseminated. In this article, we assume a starting point of EM residency and focus on pivotal training and decision points that occur along the path to matriculation into a critical care fellowship program.

Factors Associated with Delayed Cooling in Cardiac Arrest Patients.

Therapeutic hypothermia has been shown to improve neurologic outcome in medical cardiac arrest patients, yet little is known about factors that delay target temperature achievement. Our primary aim was to identify factors associated with not achieving our institutional "door-to-cool" (DTC) performance goal (emergency department [ED] arrival to temperature of 34°C) of ≤4 hours. Secondary aims included whether achievement of DTC goal was associated with timing of bolus neuromuscular blockade (NMB), survival, or functional outcome.

Assessment of the adequacy of oxygen delivery.

Purpose Of Review: This article reviews the recent literature pertaining to assessment of the adequacy of oxygen delivery in critically ill patients with circulatory shock.

Recent Findings: The assessment of the adequacy of oxygen delivery has traditionally involved measurement of lactate, central (or mixed) venous oxygen saturation (ScvO2), and global hemodynamic markers such as mean arterial pressure and cardiac index. The search for noninvasive, reliable, and sensitive methods to detect derangements in oxygen delivery and utilization continues.

Troponin Marker for Acute Coronary Occlusion and Patient Outcome Following Cardiac Arrest.

Introduction: The utility of troponin as a marker for acute coronary occlusion and patient outcome after out-of-hospital cardiac arrest (OHCA) is unclear. We sought to determine whether initial or peak troponin was associated with percutaneous coronary intervention (PCI), OHCA survival or neurological outcome.

Methods: Single-center retrospective-cohort study of OHCA patients treated in a comprehensive clinical pathway from November 2007 to October 2012.

Pleomorphic adenoma of the submandibular gland.

Pleomorphic adenomas of the submandibular glands are exceedingly rare tumors in the pediatric practice. Patients usually present with a painless and mobile mass without any other associated symptoms. Radiologic studies are usually unable to differentiate benign from malignant tumors in most cases.