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 […]
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 […]
Secondary Bacterial Peritonitis
0 Introduction with a case 0 A patient with advanced alcoholic cirrhosis presents to the hospital with fever and altered mental status. Examination is notable for abdominal distention with rebound tenderness. Bedside ultrasound reveals a large amount of ascites, which is carefully sampled revealing a cloudy fluid with 15,000 neutrophils/uL and a differential of 90% neutrophils (a […]
High-flow nasal cannula to prevent post-extubation respiratory failure
0 Background: Post-extubation failure and noninvasive ventilation (NIV) 0 Post-extubation respiratory failure requiring re-intubation is a major setback for any critically ill patient. Current evidence mainly involves the pre-emptive use of NIV to reduce post-extubation failure, particularly in hypercapnic COPD patients. However, in practice this is difficult to implement widely. Except for the sickest COPD […]
Eight pearls for the crashing patient with massive PE
0 Introduction 0 Literature on massive PE focuses mostly on how to deal with the clot while less attention is spent on other aspects of management. This post will focus on such aspects, especially hemodynamic resuscitation of massive PE. There is nearly no clinical data, forcing us to extrapolate between limited data, hemodynamic theory, and […]