Anyone who reads EMCrit knows PulmCrit and therefore its creator, Josh Farkas. We had him for virtual grand rounds at Stony Brook EM recently. This is the 1 hr GR–and it was fantastic!!!
Topics Covered Include:
- Lactated Ringers for Hyperkalemia
- Management of Submassive PE
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Hi guys, the video isn’t showing up (link seems dead). Tried on various browsers.
Scott and Josh
that was one of the finest videos and grand rounds I have ever had the privilege of watching. truly. and have seen a few. in just a short hour you two have addressed some the most salient concerns and issues faced both upstairs and down at the front door, both in those first 1-2 hours as well as the next 1-2 weeks. incredibly concise and informative ,with a very human touch.
thank you both.
I wonder if the SUNY Stony Brook Acute Critical Care grand rounds are, or can be, generally accessible.
thank you.
tom
Dear Scott & Josh,
That was a wonderful Grand Round & that’s a great format.
best wishes
Dean
Absolutely fantastic, even for us CCT Paramedics that bring some of these patients to tertiary hospitals. Please do more of these . . . THX! Chip
For A-Fib rate goals, there’s the RACE-II trial which suggests that lenient control (<110) is at least non-inferior to strict control (<80). https://www.nejm.org/doi/pdf/10.1056/NEJMoa1001337
Overall, anything less than 110 and asymptomatic, I'm happy with and the 110-130 range is generally a case by case decision.
Hi
Regarding the discussion of radial vs femoral a – lines –
Dorman T, Breslow MJ, Lipsett PA, Rosenberg JM, Balser JR, Almog Y, Rosenfeld BA. Radial artery pressure monitoring underestimates central arterial pressure during vasopressor therapy in critically ill surgical patients. Crit Care Med. 1998 Oct;26(10):1646-9. doi: 10.1097/00003246-199810000-00014. PMID: 9781720.
Great podcast ! Many fans in Israel listening to you guys !
Asaf
see here:
https://emcrit.org/pulmcrit/a-line/
Hi! Thank you for a fantastic, practical talk on such relevant topics. Do you have a recommendation for a good resource to implement a more thoughtful approach to sedation and analgesia in CICU patients? I have not seen ketamine infusion in our CICU patients at all so far for the whole first year of fellowship and based on the discussion here it seems it’s almost a routine in your practice.
All the best, thanks!
Luka
Amazing work, congrats!
Hi all,
You said that digoxin commits you to a rate control strategy. Why is this the case? If you need to cardiovert the patient (if they become more unstable), is the presence of digoxin a contraindication? Can you not do rhythm control if that becomes clinically necessary?
Can Dr Farkas provide evidence on statement about topping up steroid dosing in Covid based on CRP or other inflammatory marker profile / trend . I can only find one small Iranian study on pulse steroids to support this and limited information on risk/ benefit; and no support in any guidelines
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