30-Second Takeaway
- Use structured, severity-focused assessment and early triage for ED patients with respiratory distress; evidence quality is often low.
- In adult cardiac arrest, initial IO access does not improve 30-day survival versus IV and may reduce sustained ROSC.
- Pediatric OHCA survival with ongoing prehospital CPR falls below 1% around 15 minutes of EMS efforts.
- Early AI-assisted recognition of OHCA from emergency calls may shorten time to bystander CPR and EMS activation.
- High-dose intermittent meropenem in critically ill ICU patients was associated with lower 90-day mortality than standard dosing.
Week ending March 7, 2026
Acute respiratory and cardiovascular emergencies: new guidance for ED assessment, resuscitation, and downstream ICU care
Multisociety ED guidelines standardize initial assessment of adult respiratory distress
These French multisociety guidelines provide 20 GRADE-based recommendations for the initial ED assessment of adults with respiratory distress. They address three domains: severity assessment, triage, and diagnostic approach, structured around 13 PICO questions. Only two recommendations are strong and supported by high-quality evidence; most rely on moderate or low-certainty data and expert opinion. For three clinical questions, no recommendation was possible, underscoring persistent evidence gaps in ED respiratory distress evaluation.
Initial IO access in adult OHCA offers no survival benefit and may reduce sustained ROSC
This meta-analysis included two randomized trials with 7,561 adults with out-of-hospital cardiac arrest comparing initial IO versus IV access. IO access did not improve 30-day survival (OR 0.97, 95% CI 0.80–1.18; moderate-certainty evidence). Favorable 30-day or discharge neurologic outcome was similar between groups (OR 1.03, 95% CI 0.81–1.31; low-certainty evidence). Sustained ROSC was less likely with IO (OR 0.89, 95% CI 0.80–0.99), suggesting IV should remain first choice when quickly achievable.
Pediatric OHCA survival with ongoing EMS CPR drops below 1% by ~15 minutes
This ROC registry cohort studied 1,313 EMS-treated, nontraumatic pediatric OHCAs in the US and Canada. Overall survival to hospital discharge was 10.4%, with prehospital ROSC in 18.0% at a median EMS CPR duration of 10 minutes. Among children still receiving CPR, conditional survival probability fell from 7.9% at 1 minute to under 1% at 14.8 minutes. The upper 95% CI for survival probability dropped below 1% at 22 minutes, informing discussions about field termination and ED continuation.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.