Clinical question For patients presenting with early septic shock, does early goal-directed therapy reduce mortality? Bottom line As compared with usual resuscitation care, early goal-directed therapy (EGDT) using central venous monitoring does not improve mortality in patients presenting to the emergency department with septic shock. Reference ARISE Investigators; ANZICS Clinical Trials Group, Peake SL, et… [Read More]
Clinical question Does a lower transfusion threshold for critically ill patients with septic shock affect outcomes? Bottom line Using a lower threshold for transfusion for patients with septic shock in the intensive care unit (ICU) decreases the number of transfusions received without affecting mortality. Reference Holst LB, Haase N, Wetterslev J, et al. Lower versus… [Read More]
69%: the percentage of hospitals that had perfect compliance with the Leapfrog Group employer coalition’s safe practices for hand hygiene in its 2013 annual quality survey of 1,437 U.S. hospitals. The CDC estimates 2 million patients annually acquire hospital-acquired infections (HAIs), often spread by contaminated hands of healthcare workers. Urban hospitals performed better than rural… [Read More]
Steven Z. Pantilat, MD, SFHM, medical director of the University of California San Francisco School of Medicine palliative care service, explains palliative care is not end-of-life care, and the role hospitalists should play in palliative cases.
Josiah Halm, MD, and Sahitya Gadiraju, DO, assistant professors of general internal medicine at M.D. Anderson Cancer Center in Houston, discuss the breadth of care provided to cancer patients, a risk assessment being developed there on readmission risk, and factors in care that go beyond the medical.
Dear Editor: Excellent article on hyponatremia management in the August 2014 issue. I would like to point out a possible error/typo in Figure 2 on page 12. In the flowchart, the third category is described as “HYPOvolemia,” with causes mentioned as congestive heart failure, cirrhosis, nephrotic syndrome. Did the authors mean HYPERvolemia? Thanks again for… [Read More]
Case A 56-year-old woman with hypertension and diabetes presents to the hospital with acute onset of painful swelling in her right calf. She has had no recent surgeries, trauma, or travel, and takes lisinopril and metformin. An ultrasound of her right lower extremity demonstrates a venous thromboembolism (VTE). The patient’s last mammogram was three years… [Read More]
When should treating a cancer patient become more about controlling symptoms and making the patient comfortable than about trying to slow the cancer itself? Hospitalists, who often care for patients in the worst stages of health, regularly make important observations that result in a patient transitioning to hospice care. When such a case is suspected,… [Read More]
Patients might come into a hospitalist’s care when they are in the middle of a clinical trial. What then? The first step for a hospitalist is to find out whether a patient is enrolled in a trial. “The safety and health of a patient obviously are more important than anything else,” Dr. Khuri says, “but… [Read More]
Things you need to know An occasional series providing specialty-specific advice for hospitalists from experts in the field. COMING UP: 10 Things Endocrinologists Want HM to Know Archived: @the-hospitalist.org 10 Things Infectious Disease 12 Things Cardiology 12 Things Nephrology 12 Things Billing & Coding Cancer patients can be some of the most complicated and high-stakes… [Read More]