In this 3rd post for JanuAirway, I am joined by airway educator extraordinaire: George Kovacs.
EMCrit Wee – Preoxygenation Update 2015
It’s Janu-Airway: Here’s a little update on preox (you know the topic I think about 20 hours a day)
The Respiratory Death Airway Algorithm
0 Introduction 0 Last week Scott Weingart discussed a case of a profoundly hypoxemic patient with a failed airway which was salvaged by surgical cricothyrotomy (listen to it here). Despite successfully resuscitating the patient there was some criticism later that perhaps a cricothyrotomy wasn’t absolutely required. This reminds me of a case I’ve been planning […]
Toxic Shock Syndrome Management: A tale of two patients
0 Introduction 0 Toxic shock syndrome (TSS) is a true resuscitationist’s disease. It is potentially quite lethal, with many series of streptococcal toxic shock syndrome reporting mortality in the range of 30-50%. However, recent observational studies suggest that treatment with modern critical care, toxin-suppressive antibiotics, and IVIG may reduce the mortality to 10% (Linner […]
EMCrit 141 – A Janu-Airway Case Presented Live
A case of anatomically and physiologically difficult airway presented live at #EMCritConf 2015.
The Case of the Balanced Solution
Saline-based resuscitation strategies were first proposed as far back as 1831 during the Cholera Epidemic. In an article published in the Lancet in 1831, Dr. O’Shaughnessy suggests the use of injected salts into the venous system as a means of combating the dramatic dehydration seen in patients afflicted with this bacterial infection(1). Saline’s potential harms […]
Early suspicion of toxic shock syndrome
0 Introduction 0 Toxic shock syndrome (TSS) is critical to recognize because it can be rapidly lethal and yet is usually treatable. TSS is a relatively new disease, first described in 1978. The prevalence has increased over the last few decades due to shifts in the circulating strains of Group A streptococcus (Low 2013). However, […]
EMCrit 140 – Top Picks for 2014
Welcome to our annual rehash of the goodness of the past year.
Treating delirium tremens: Pharmacokinetic engineering with diazepam and phenobarbital
0 [PLEASE NOTE: For the most complete & updated material on alcohol withdrawal, please see the Internet Book of Critical Care Chapter on this topic here] 0 Introduction 0 Recently the New England Journal published a review article about delirium tremens which is somewhat misguided (see a scathing critique by The Poison Review). The […]
Holiday break & Comic relief
Introduction: Medicine is stressful. Humor helps. Here are some of the funniest medical videos I’ve seen. If there is a video you love that’s not here, drop it in the comments section. Disclaimer: These videos are intended only for healthcare professionals with intact senses of humor. They contain some foul language. Watch them at your […]
Enhancing Human Performance in Resuscitation Part 1: Going With The “Flow”
Mike Lauria on optimizing flow
A Secondary Examination of The Adventure of the Cardboard Box-Addendum
Published in the NEJM on December 17th 2014, ushered in with the inflated fanfare only the medical industry capable of, MR CLEAN marks the first successful trial of interventional therapy for acute ischemic stroke. In direct contrast to IMS-3, SYNTHESIS and MR RESCUE, MR CLEAN is a significantly positive trial. The authors demonstrated success in […]
Mythbusting: (Empty IVC + hyperkinetic heart) does not equal volume depletion
0 Introduction with an example 0 A 60-year-old woman is admitted with septic shock due to pyelonephritis. Currently she has received two liters of crystalloid. Her mean arterial pressure is now 55 mm, her pulse is 120 b/m, and she is producing very little urine. Bedside ultrasound shows that her IVC is completely empty (sometimes […]
EMCrit 139 – Opioid-Free ED with Sergey Motov
Can we manage pain more effectively without Opioids?
Renoresuscitation: Sepsis resuscitation designed to avoid long-term complications
0 Introduction 0 Over the last few years, I’ve gone through an almost 180-degree change in my conceptualization of septic shock. In a perfect world, this would be irrelevant. Ideally there would be sufficient randomized controlled trials (RCTs) to answer all important questions directly, and my opinions would be irrelevant. Unfortunately not. Reconceptualizing the disease […]
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