PulmCrit (EMCrit)

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 […]

So, the new IDSA guidelines for community acquired pneumonia (CAP) are here.  This post will walk us through the guidelines, focusing primarily on issues that relate to critically ill patients.  Guidelines can get dull, I’ve added in GIFs to illustrate my feelings about each recommendation & kept things pretty informal.  Come for the GIFs, stay […]

Methemoglobinemia is one of my favorite toxicology diagnoses.  The diagnosis can often be made at the bedside based on history and physical examination, which is a satisfying bit of detective work.  Once the diagnosis is made, patients generally respond promptly to a specific antidote (methylene blue).  And this isn’t just a parlor trick – diagnosis […]

preamble CRASH-3 is the latest massive, pragmatic multi-center RCT brought to us by the London School of Hygiene and Tropical Medicine Trials Unit.  These investigators have created an extensive network of hospitals throughout the world with the capability of performing truly impressive trials.  Especially in the critical care arena, these trials have uniquely high power […]