PulmCrit (EMCrit)

Catastrophic antiphospholipid syndrome (CAPS) is a truly rare cause of multi-organ failure.  It is usually not considered as a diagnostic possibility, leading it to be mis-diagnosed as septic or cardiogenic shock.  Awareness of this condition and various red flags suggesting its presence might facilitate earlier diagnosis and therapy. The IBCC chapter is located here. The […]

Familiarity breeds contempt.  Fever is so common in the ICU, that we often don’t put much thought into these workups.  Just culture everything, right?  Well, not really.  Excessive cultures frequently lead to false-positive results (representing colonization), which serve only to misdirect attention away from the actual problem.  Meanwhile, inadequate attention to the physical examination and […]

Catheter-associated urinary tract infection (CAUTI) is supposedly one of the most common causes of nosocomial infection.  However, it’s dubious to what extent it is truly a disease.  It’s increasingly clear that the vast majority of cases of “CAUTI” are likely merely asymptomatic bactiuria, which has been mis-diagnosed as infection (leading to unnecessary treatment and iatrogenic […]

Sickle cell disease affects 100,000 people in the United States and far more internationally.  One of the most dangerous manifestations of the disease is acute chest syndrome, which involves a vicious cycle of erythrocyte sickling and respiratory failure.  Acute chest syndrome can be a presenting feature upon hospital admission, it can arise as a complication […]

The hard part about playing chicken is knowing when to flinch – Bart Mancousco, The Hunt for the Red October Epiglottitis is often a game of chicken.  The great majority of adult patients don’t require intubation, so the best management for them is steroid and antibiotic (plus close observation and the ability to intubate if […]