Convalescent plasma and COVID @StrongMed

Uploaded August 2020 | Updated September 2026, 1 week ago

A hot take on the evidence for convalescent plasma as a COVID treatment and the FDA's emergency use authorization.

Effect of Convalescent Plasma on Mortality among 2 Hospitalized Patients with COVID-19: Initial Three3 Month Experience (i.e. the only evidence the FDA used for their EUA): medrxiv.org/content/10.1101/2020.08.12.20169359v1.full.pdf

A good discussion of the state of evidence for convalescent plasma (and why we've had no good RCTs!): wired.com/story/97000-people-got-convalescent-plasma-who-knows-if-it-works

A discussion of relative vs. absolute risk reduction: ncbi.nlm.nih.gov/pmc/articles/PMC4763519

As always, respectful dialogue is welcome. Insults, trolls, and pseudoscience are not. These comments are moderated.

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$The Pulmonary Exam / Lung Sounds (Strong Exam) A deep dive on the core pulmonary exam - the exam of the lungs that one would perform on a new primary care patient, or on a patient being admitted to the hospital for an issue not directly related to the lungs. I discuss abnormal respiratory patterns, signs of respiratory distress, barrel chest, clubbing, and of course, lung auscultation (e.g. crackles, wheezes, rhonchi, etc...) @0:00 Introduction @1:40 Inspection of the respiratory pattern @5:31 Remainder of inspection (e.g. resp. distress, barrel chest, clubbing) @12:27 Review of lung anatomy for auscultation @13:57 Demonstration of lung auscultation @17:30 Lung Auscultation - breath sounds @19:25 Lung Auscultation - adventitious sounds (e.g. crackles, wheezing) @27:34 Concluding clinical pearls & documentation of the lung exam References: McGee S. Evidence Based Physical Diagnosis. 5th Ed. Elsevier; 2021. Hooker EA, O’Brien DJ, Danzl DF, Barefoot JAC, Brown JE. Respiratory rates in emergency department patients. J Emerg Med. 1989;7:129–132. McFadden JP, Price RC, Eastwood HD, Briggs RS. Raised respiratory rate in elderly patients: a valuable physical sign. Br Med J. 1982;284:626–627. McGee SR. Cheyne-Stokes breathing and reduced ejection fraction. Am J Med. 2013;126:536–540. de Mattos WL, Signori LGH, Borges FK, Bergamin JA, Machado V. Accuracy of clinical examination findings in the diagnosis of COPD. J Bras Pneumol. 2009;35:404–408. Pierce JA, Ebert RV. The barrel deformity of the chest, the senile lung and obstructive pulmonary emphysema. Am J Med. 1958;25:13–22. Golub RM. Validity and Reliability of the Schamroth Sign for the Diagnosis of Clubbing. JAMA. 2010;304:159-161. Holleman DR, Simel DL. Does the Clinical Examination Predict Airflow Limitation? JAMA. 1995;273:313-319. Piinla P, Sovijarvi ARA. Crackles: recording, analysis and clinical significance. Eur Respir J. 1995;8:2139-2148. Wang CS, et al. Does This Dyspneic Patient in the Emergency Department Have Congestive Heart Failure? JAMA. 2005; 294:1944-1956. #physicalexam #respiratory #OSCE$