Historically, emphasis has rested on the distinction between noninvasive versus invasive BP (e.g., cuff pressure vs. radial arterial pressure). Attention focused on whether noninvasive oscillometric BP monitoring is adequate. Meanwhile, it has been assumed that all invasive BP measurement sites are created equal.
Search Results for: femoral arterial catheterization
The Case of the Blind Allocator
In the modern world of evidence based medicine we exist in a perpetual state of doubt, continually attempting to perceive truths through the veil of science. Far too often our sample cohort deviates from the population it intends to represent. Hypothesis testing and frequentist statistics are tools intended to quantify the extent to which the […]
Hemodynamic access for the crashing patient: The dirty double
0 0 Introduction with a case 0 A 75-year-old man presents in transfer to the ICU for management of bradycardia and hyperkalemia. His history is notable for hypertension with chronic use of an ACE-inhibitor. He developed gastroenteritis due to endemic Norovirus some days prior. Today he presented to the outside hospital with hypotension and […]
EMCrit 121 – REBOA
This episode, we discuss REBOA (resuscitative endovascular balloon occlusion of the aorta).
Line infection
CONTENTS Rapid Reference 🚀 Physiology Prevention Clinical features Diagnosis Management Overall strategy Empiric antibiotic selection Treatment duration Persistent bacteremia Specific situations Septic thrombophlebitis Arterial line infection Chest port infection Podcast Questions & discussion Pitfalls various mechanisms of infection: Early infections often arise from the skin: (a) These may occur during line insertion. (b) There may […]
Does central line position matter? Can we use ultrasonography to confirm line position?
. Introduction . Suppose you just placed the central line shown above. Does it need to be repositioned? . I was trained that the tip of the central line must lie in the lower portion of the superior vena cava. If the line was in the right atrium, it would cause cardiac perforation. If the […]
EMCrit 57 – Resuscitative Extra-Corporeal Life Support (ECMO)
Joe Bellezzo, MD along with his partner-in-crime, Zack Shinar, MD have started an ED ECMO service at Sharp Memorial Hospital in San Diego. I am so jealous! In this episode of the podcast, I get to talk to Joe about how it works.
EMCrit 210.1 – Arterial Lines (Part 1)
All things Arterial Lines-Part 1
EMCrit 170 – the ER REBOA Catheter with Joe DuBose
Resuscitative REBOA is interesting, but was probably too complex for Resus Doctors–well not anymore!
PulmCrit- Shrug Technique for US-guided subclavian lines
The CDC guidelines recommend placing subclavian lines to reduce the risk of catheter-related bloodstream infections. Meanwhile, mounting evidence suggests that we should probably be placing lines with ultrasound guidance. Unfortunately, the ultrasound-guided subclavian can be tricky. This post describes a slight modification that could make the technique easier and safer.
Frequently Asked Questions (FAQ) regarding Sepsis
Severe Sepsis FAQ The FAQ below was designed to provide teams with a concise framework to describe the clinical rationale for undertaking the non-invasive and invasive severe sepsis protocols, and to link evidence and clinical resources to the protocols. The following sections outline key features of the components of the severe sepsis invasive and non-invasive […]
Massive Transfusion Protocol (MTP)
CONTENTS Rapid Reference 🚀 Introduction to massive transfusion protocol (MTP) Procedural concerns Running the MTP 1) Blood products in 1:1:1 ratio 2) Fibrinogen supplementation? 3) Tranexamic acid? 4) Reversal of other coagulopathies 5) Calcium 6) Avoid acidosis 7) Avoid hypothermia 8) Hemodynamic management 9) Source control Post-MTP assessment & management Podcast Questions & discussion Pitfalls […]
EMCrit Guest Post – The good, the bad, and the ugly of the Joint Statement on REBOA by Zaffer Qasim
@emeddoc on the current state of REBOA and that bad, bad joint agreement:
PulmCrit- High dose vasopressors: Never surrender
Every hospital and pharmacopeia have their own “maximum dose” of vasopressors. Which one is correct?
NeuroEMCrit – Everything you wanted to know about Hyperosmolar agents for the Management of ICP and Cerebral Edema
Everything you wanted to know about Hyperosmolar agents for the Management of ICP and Cerebral Edema