Management of severe heart failure and cardiogenic shock is difficult. There is a notable lack of high-quality evidence regarding the sickest patients. Treatment strategies validated among more stable patients may not be applicable to the most unstable heart failure patients.
Severe hypoglycemia can be scary, especially when the patient isn’t responding to front-line therapies (e.g. IV dextrose). However, some unconventional tools and an organized approach can make this extremely manageable.
I should do a formal retrospective cohort study on this, but I don’t have time. Fortunately, the ICU group at Northshore/Long Island Jewish has done exactly that.
Bradycardia emergencies are uncommon, but these cases can go sideways fast. An appropriately aggressive approach is needed to avoid cardiac arrest. Sometimes the answer is as simple as the appropriate epinephrine dose.
Sir William Osler called pneumonia “the captain of the men of death.” Over a century later, pneumonia remains the leading cause of infectious death in the developed world.