the battle between the ivory tower academics vs. the rogue cowboys An internecine war is brewing about the treatment of COVID-19. You can hardly open up a journal or look at social media without getting caught in the cross-fire. The cause of the schism is pretty simple. There are no proven treatments for COVID-19. Based […]
PulmCrit Wee: Lung pathology of COVID-19: is AFOP in play?
We’re beginning to start to see some information about lung pathology due to COVID-19. But before jumping into that, a little background… background: lung pathology, DAD, and AFOP Lung pathology & treatment: the bigger picture In an ideal world, different insults to the lung would cause specific histologic patterns. These patterns would be related to […]
Invictus: Survival, Sustainment, and Service in the Era of COVID-19
Invictus – William Ernest Henley These are difficult and challenging times. The current situation with the pandemic is unprecedented. The impact it has imposed in terms of economic cost, human suffering, and strain on our healthcare teams around the globe is unbelievable. Furthermore, while there is a glimmer of hope on the horizon, the […]
EMCrit – Mental practice in the COVID19 era: Mastering PPE
How do you learn high priority, low practice-iteration skills?
PulmCrit Wee – Some take-home messages about the COVID experience in New York
Currently, three publications are available describing coronavirus outcomes among hospitalized patients in New York: Goyal et al: 393 patients at Cornell. Cummings et al: described 257 patients who were critically ill (among a total of 1,150 patients at Columbia and a community affiliate). Richardson et al: 5700 patients at Northwell Health System (including North Shore […]
EMCrit Wee – COVID Ventilation Round Table Discussion
idea lobbing
EMCrit Guest Post – COVID – The anticipated difficult and protected airway: A case study
Case report of a COVID airway with discussion and checklists
PulmCrit- Timed & titrated use of steroid in COVID-19?
Guideline recommendations on steroid use in COVID are contradictory. For example, the Surviving Sepsis Campaign recommends steroid for intubated patients with COVID and ARDS,1 whereas the IDSA guidelines recommend that steroid should be restricted to randomized controlled trials. Reviewing these documents shows that they often lean on data from influenza and MERS, which may not […]
PulmCrit – Defining ARDS & recruitability, with implications for COVID treatment
In the past few weeks, there has been considerable debate regarding whether or not early COVID respiratory failure is ARDS. This is a linguistic mess, but it has real implications for treatment. So, it’s worth trying to sort it out… definition(s) of ARDS When clinicians use the term “ARDS” they are referring to a variety […]
EMCrit 271 – Additional, Additional COVID Airway Thoughts with the Actual Audio this Time
Including the Intubation-Monkey Checklist
PulmCrit – Hydroxychloroquine fails first meaningful RCT
Hydroxychloroquine has been a highly controversial potential treatment for COVID-19. To date, available evidence has consisted of in vitro data as well as some heavily flawed studies from France. A new pre-print from China offers the most meaningful investigation of hydroxychloroquine to date. design Tang et al. is a multi-center, open-label RCT involving administration of […]
PulmCrit – Understanding happy hypoxemia physiology: how COVID taught me to treat pneumococcus
Happy hypoxemia is severe hypoxemia (poorly responsive to supplemental oxygen) without dyspnea. This isn’t anything especially new – we have occasionally seen this since time immemorial. However, COVID is causing us to re-think how to manage this physiology. understanding the paradox of happy hypoxemia The key to understanding this is thinking about oxygenation and CO2 […]
Extubating COVID Patients with thoughts from Guest EMCritter, Sahar Ahmad
If you put it in, you need to be able to take it out.
ThinkingCC COVID Respiratory Management Webinar
cutting edge info on COVID19 management
PulmCrit – Eleven reasons the NEJM paper on remdesivir reveals nothing
Grein et al. just published a case series of patients with COVID-19 treated with remdesivir via a compassionate use program. I’ve been expecting this paper with cold dread for some time now. There are several reasons that this publication is a media show, rather than a serious scientific endeavor. #1. Lack of a control group […]
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