EMCrit Podcast 20 – The Crashing Atrial Fibrillation Patient

shocking_gremlin

Your patient is pale and diaphoretic. Blood pressure is 70/50. Heart rate is 178. EKG shows atrial fibrillation... What are you going to do??? Yeah, yeah the Pavlovian ACLS response--You cardiovert. Wonderful, except it didn't change a thing. Now what? In this episode, I discuss the crashing atrial fibrillation patient. Shock If the patient is chronically in atrial fib, … [Read more...]

Podcast 10 – Cardiogenic Shock

heart

Mohamed, a listener from Sudan, emailed asking about the treatment of acute pulmonary edema in patients with low blood pressure. This is in distinction to SCAPE patients (see podcast 1). If the patients have pulmonary edema and low BP from a cardiac cause, then they are in cardiogenic shock. First, consider the etiology: Rate-related Valve Disorder Ischemic (Right … [Read more...]

EMCrit Podcast 6 – Push-Dose Pressors

vice

Finally a non-intubation topic! Bolus dose pressors and inotropes have been used by the anesthesiologists for decades, but they have not penetrated into standard emergency medicine practice. I don’t know why. They are the perfect solution to short-lived hypotension, e.g. post-intubation or during sedation. They also can act as a bridge to drip pressors while they are … [Read more...]