『PRISM Rounds: Pulmonary, Critical Care & Sleep Medicine』のカバーアート

PRISM Rounds: Pulmonary, Critical Care & Sleep Medicine

PRISM Rounds: Pulmonary, Critical Care & Sleep Medicine

著者： bronchoscope
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概要

 PRISM Rounds is a Pulmonary, Critical Care & Sleep Medicine podcast that reviews one new article every other week. We break down the study design, statistics, results, and bedside implications—so you can interpret the trial quickly and stay current with the latest research.bronchoscope 衛生・健康的な生活 身体的病い・疾患
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  • S01E22 2026 AHA/ASA Stroke Guideline: Tenecteplase, Thrombectomy Expansion, and Bedside Workflow

    S01E22 2026 AHA/ASA Stroke Guideline: Tenecteplase, Thrombectomy Expansion, and Bedside Workflow
    2026/03/02

    Stroke alert at 2 a.m. hits different—so in S01E22 we run playful “teaching rounds” on the AHA/ASA 2026 Guideline for the Early Management of Acute Ischemic Stroke, published in Stroke. We translate the biggest recommendations into what you actually do at the bedside: EMS prenotification and destination decisions, rapid imaging workflows (and what not to delay), IV thrombolysis decisions including tenecteplase vs alteplase within the 4.5-hour window, and how to approach disabling vs non-disabling symptoms when NIHSS looks “low.”

    Then we shift to endovascular therapy: what “expanded eligibility” means in practice, including selected patients with larger ischemic cores, and the guideline’s support for basilar artery occlusion thrombectomy in the appropriate window. We close with the underrated outcome-shapers—glucose and blood pressure targets (including what to stop doing out of habit), plus early complications like dysphagia/aspiration risk.

    Designed for trainees and FOAMed listeners: high-yield, practical, and just enough stroke-alert banter to keep you awake.


    PubMed:


    https://pubmed.ncbi.nlm.nih.gov/41582814/


    Tags

    #Stroke #AcuteIschemicStroke #Neurology #EmergencyMedicine #CriticalCare #ICU #FOAMed #AHA #ASA #Guidelines #StrokeAlert #Thrombolysis #Tenecteplase #Alteplase #MechanicalThrombectomy #EndovascularTherapy #BasilarArteryOcclusion #LargeVesselOcclusion #NeurocriticalCare #EMS #Telestroke #CTAngiography #BPManagement #GlucoseControl #Dysphagia
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    28 分
  • S01E21 Acute Pulmonary Embolism: 2026 AHA/ACC Multisociety Guideline

    S01E21 Acute Pulmonary Embolism: 2026 AHA/ACC Multisociety Guideline
    2026/02/27

    We walk through the 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN guideline for evaluation and management of acute pulmonary embolism in adults (Circulation, 2026). We focus on the guideline’s top take-home messages trainees need on rounds: the new A–E clinical categories for severity/triage, who can be discharged early, who should be hospitalized, when to activate PERT, and how to think about escalation therapies in the sickest patients—plus practical anticoagulation choices (LMWH vs UFH, DOACs vs warfarin) and follow-up to screen for post-PE limitations/CTEPD. Educational use only—not medical advice.

    Source (guideline):

    https://www.ahajournals.org/doi/10.1161/CIR.0000000000001415


    Pubmed: https://pubmed.ncbi.nlm.nih.gov/41712677/

    Tags

    #CriticalCare #ICU #PulmonaryEmbolism #PE #VTE #Thrombosis #Anticoagulation #DOAC #Heparin #LMWH #PERT #EmergencyMedicine #HospitalMedicine #Cardiology #PulmonaryMedicine #MedEd #FOAMed #Guidelines #Circulation #ResidentEducation #FellowEducation #RVRstrain #CTPA #D_Dimer #CTEPD
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    42 分
  • S01E20 PreVent 2 and Subglottic Secretion Drainage After Emergency Intubation (Lancet Respir Med)

    S01E20 PreVent 2 and Subglottic Secretion Drainage After Emergency Intubation (Lancet Respir Med)
    2026/02/24
    On today’s PRISM Rounds we discuss PreVent 2, the multicenter randomized trial in The Lancet Respiratory Medicine (2025) testing whether a polyurethane cuff + subglottic secretion drainage (PU-EVAC) endotracheal tube improves outcomes after emergency intubation—and what the accompanying editorial argues about the real-world value of subglottic suction devices.We translate the methods and results into what matters on shift: CDC ventilator-associated event metrics (IVAC / possible VAP), workflow realities (cuff pressure checks, suction setup), and why “VAP reduction” only matters if it moves objective outcomes. We also step back to the 2016 AnnalsATS Deem et al. pilot trial as historical context—then return to the core question: should these tubes be routine in emergency intubations, or is it time to move on?Friendly ICU banter included (with love for RTs and nursing). Educational use only.Sources (PubMed):PreVent 2 (Lancet Respir Med, 2025):https://pubmed.ncbi.nlm.nih.gov/41319662/Deem et al. pilot (AnnalsATS, 2016): https://pubmed.ncbi.nlm.nih.gov/26523433/Tags#CriticalCare #ICU #MechanicalVentilation #AirwayManagement #Intubation #VAP #VentilatorAssociatedPneumonia #VentilatorAssociatedEvents #IVAC #SubglotticSuction #EndotrachealTube #RespiratoryTherapy #Nursing #FOAMed #MedEd #JournalClub #EvidenceBasedMedicine #LancetRespiratoryMedicine #AnnalsATS
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    48 分
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