PulmCrit (EMCrit)

example 1: anti-emetics Let’s get started with a RCT comparing droperidol versus ondansetron for the treatment of nausea in the emergency department.  Meek et. al randomized 144 nauseated patients to receive either droperidol or ondansetron.​1​  The rates of symptom improvement were indistinguishable (75% vs 80%).  So, you might conclude that these drugs are equally efficacious. […]

In the northern hemisphere, Winter is Coming.  Folks are firing up their furnaces – some of which may have an inadequate oxygen supply, thereby generating carbon monoxide.  Unfortunately, the diagnosis of carbon monoxide poisoning is extremely hard to make, mimicking many different conditions.  In particular, carbon monoxide poisoning can mimimic influenza – which is also […]

Myocardial infarction patients are complex.  Unfortunately, this complexity can grow over time.  Delayed deterioration in the patient recovering from MI may result from a host of different problems (e.g. medication effect, procedural complications, or merely the natural history of the disease).  This chapter explores some problems that we should be on the lookout for in […]

We’ve been all over the road with beta-blockers and COPD.  For a long time, there was a belief that beta-blockers were contraindicated in COPD.  Eventually that concept fell out of favor.  Subsequently, some correlative data suggested that beta-blockers might be beneficial in COPD.  This led to the current BLOCK-COPD trial which (spoiler alert) shows that […]

I’m afraid she will tank after intubation, could you start some fluid? I brought a liter of fluid, just in case the blood pressure falls after intubation.  He is decompensating!  Run the fluid wide open! We’ve all probably heard and spoken those phrases.  Crystalloid is a traditional therapy in efforts to either prevent or mitigate […]