In medicine we frequently propagate half-truths and unsubstantiated certainties. Thus, truth is a relative experience, dependent primarily on how we choose to define it rather than any concrete state of reality. Increasingly we have favored a technological definition of truth over that of the clinical perspective. As such we are driven to act in disease […]
What does it mean if a patient is “allergic” to haloperidol?
0 Introduction with a case 0 Once upon a time at Genius General Hospital, a 25-year old man was admitted to the ICU for agitation. After exclusion of an acute medical or neurologic process, it became clear that he was suffering from schizophrenia with medication nonadherence. Unfortunately, his electronic medical record indicated that he had […]
EMCrit 131 – Cricothyrotomy – Cut to Air: Emergency Surgical Airway
Comprehensive information of surgical airway, cricothyrotomy, and the bougie cric
The myth of large-volume resuscitation in acute pancreatitis
Introduction 0 Severe pancreatitis causes fluid extravasation from the vasculature, sometimes causing shock. Traditionally this has been managed by administration of large volumes of crystalloid. For example, the 2013 American College of Gastroenterology Guideline recommended providing 250-500 ml/hour of crystalloid for the first 12-24 hours of hospitalization. They recommended targeting fluid resuscitation to achieve dilution […]
EMCrit Wee – A Case to Threaten Current ECMO Evidence from Sam Ghali
Should we be extending ACLS in patients we really want to save?
A Secondary Analysis of the Adventure of the Crooked Man
Removing a cervical collar in the early aftermath of a traumatic injury is becoming an increasingly difficult task. With ever more sensitive imaging modalities we have progressively devalued the traditional methods used to evaluate the integrity of the spinal column in favor of more technologically advanced ones. Despite decades of success in treating this pathology, […]
Table-of-Contents and FOAMcc in One Bolus
All the journal goodness
The fallacy of time-to-intervention studies
0 Time and tide wait for no intervention – Geoffrey Chaucer 0 We are barraged by time-to-intervention studies (door-to-balloon time, time-to-antibiotics, door-to-needle, etc.). However, it must be kept in mind that these studies are purely correlational in design. Such studies cannot […]
EMCrit 130 – Hemodynamic-Directed Dosing of Epinephrine for Cardiac Arrest
Today on the podcast, I address the last little bit from my SMACC lecture on the new management of the intra-arrest: hemodynamic, individualized dosing of epinephrine.
Ebola Diagnosis and Treatment
Just in Case…
Could estrogen-receptor antagonists treat Ebola?
Disclaimer: In light of the ongoing epidemic this post is intended to spark interest and invoke discussion about unconventional therapies. Introduction It is widely believed that there is no specific therapy for Ebolavirus. However, this is only partially true. Some experimental therapies exist, including convalescent serum and interferon, but the ability to deploy these to […]
MotR – Mike Lauria on “Making the Call”
You’ll be hearing more from Mike
Two EKG patterns of pulmonary embolism which mimic MI
Introduction with a case 0 A 45-year old man presented to the hospital with chest pain and dyspnea. His troponin was positive, and EKG showed T-wave inversions in the inferior leads and V1-V4. He was pale, diaphoretic, tachycardic, and borderline hypotensive with a systolic blood pressure ranging from 85-110mm. He was taken urgently for cardiac […]
EMCrit 129 – LAMW: The Neurocritical Care Intubation
This is the another of the Laryngoscope as a Murder Weapon lectures; though in this case it is really more of an aggravated assault.
2 Pitches
Airway Course and Neurocritical Care Course
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