Posterior Reversible Encephalopathy Syndrome (PRES) is a common cause of ICU admission for seizure or altered mental status. Although PRES is commonly associated with hypertension, PRES can occur in the absence of hypertension due to a variety of disorders that impair endothelial function causing vasogenic edema. Thus, PRES encompasses the entity of “hypertensive encephalopathy” – […]
PulmCrit – A history of hypothermia for cardiac arrest, 2002-2021 (RIP)
Let’s start by considering what our pretest probability should be regarding whether hypothermia is beneficial after cardiac arrest. Every enzyme in our body has been evolutionarily designed to function at our normal body temperature. Therefore, hypothermia will affect every chemical pathway. As such, hypothermia is an incredibly blunt tool. It’s hard to think of any […]
EMCrit 300 – Airway Continuous Quality Improvement and the Resus Airway Bundle
If you are not measuring your success, it probably is not that great
IBCC – Reversible Cerebral Vasoconstriction Syndrome (RCVS)
Reversible Cerebral Vasoconstriction Syndrome (RCVS) is an important cause of stroke and intracranial hemorrhage, especially in younger people. This disorder may also complicate other neurologic disorders, especially Posterior Reversible Encephalopathy Syndrome (PRES). The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes
NeuroEMCrit – Clinical Pearls for Coma
Clinical pearls on the exam and differential of coma patients
IBCC – Paroxysmal sympathetic hyperactivity
Paroxysmal sympathetic hyperactivity (previously known as sympathetic storming) is a pattern of recurrent episodic sympathetic activation which may occur after severe brain injury (most often traumatic or anoxic). Prompt recognition of this diagnosis may facilitate appropriate treatment, thereby stabilizing the patient and avoiding aggravation of the underlying brain injury. The IBCC chapter is located 👉 […]
IBCC – Autoimmune Encephalitis
Autoimmune encephalitis was nearly unknown a few decades ago, but currently it’s estimated that it may be as common as HSV encephalitis. Given that many forms respond well to treatment, prompt diagnosis is critical. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes
EMCrit 299 – Bougie Masterclass with George Kovacs
All things Bougie…
IBCC – Elevated intracranial pressure (ICP)
ICP elevation is an important dimension of many neuroICU patients. Unfortunately, it remains unclear precisely who might benefit from ICP monitoring, or exactly what the optimal ICP targets should be. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes
Logistics of Whole Bowel Irrigation (WBI) for Toxicologic Overdose
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IBCC – Critical care nutrition
Critical care nutrition is a perpetually challenging topic, due to the difficulty in performing high-quality research on it. This chapter aims to describe reasonable practices, based largely on the 2019 ESPEN guidelines. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes
IBCC – Cardiac glycoside poisoning (including digoxin)
Cardiac glycoside poisoning continues to be a relevent topic, due to both digoxin and plants containing cardiac glycosides. As with all things toxicologic, ongoing debate surrounds the precise dosing and indications for anti-digoxin antibody fragments. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes
EMCrit 298 – Calcium in Exsanguinating Patients with Ricky Ditzel and Jeffrey Siegler
Something I have been preaching for a decade has finally gotten the attention and research it deserves. On this episode, I get two of the authors from the Lethal Diamond Paper to discuss hypocalcemia in the bleeding patient.
IBCC – Approach to the poisoned patient
Poisoning is one of the most common causes of ICU admission. The vast majority of these patients do fine, with minimal supportive therapy and observation. However, occasional patients will progress to organ failures and potentially death. This chapter explores how to approach these patients, with an eye towards identification and prompt treatment of the critically […]
IBCC – Thrombotic microangiopathies (TTP, HUS, et al.)
Thrombotic microangiopathy is a rapidly moving target, which has evolved considerably in just the past few years. Complementopathies (e.g., atypical hemolytic uremic syndrome) probably represent a largely unappreciated, yet critical, dimension of many diseases. Thrombotic thrombocytopenic purpura (TTP) remains an important hematologic emergency that must be promptly recognized. This chapter attempts to disentangle these entities, […]
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