This concept was first conceived by the authors above in 2006 and discussed in national lectures in 2007 and on. It has been available on emcrit.org since March 2008 and was the first hit on a google search of ‘RUSH Exam’ from this date on. It was published on Emedhome in May 2009. Rapid […]
Search Results for: acid base
NeuroEMCrit – Everything you wanted to know about Hyperosmolar agents for the Management of ICP and Cerebral Edema
Everything you wanted to know about Hyperosmolar agents for the Management of ICP and Cerebral Edema
“The Adventure of the Second Stain”
Subarachnoid Hemorrhage (SAH) is one of the more angst-inducing pathologies an Emergency Physician faces on a daily basis. A disease for which we have a well established diagnostic pathway. The strategy of non-contrast CT followed by a lumbar puncture (LP) has been showed to effectively eliminate the risk of SAH (1). And yet there is […]
CT Angiogram for evaluation of severe hematochezia
Introduction 0 Gastrointestinal hemorrhage is a common reason for ICU admission. The approach to severe upper GI bleeding is relatively straightforward (figure below). A predictable approach facilitates planning ahead, and anticipating who needs to be contacted for help when. 0 0 Unfortunately, the approach to severe hematochezia is often less clear. Below is a description […]
IBCC chapter & cast: Abdominal Compartment Syndrome
Abdominal compartment syndrome can result from primary abdominal pathology (e.g. bowel obstruction), but it can also occur due to systemic inflammation combined with large-volume resuscitation. As such, abdominal compartment syndrome is probably more frequent than generally perceived, functioning as an occult driver of multi-organ failure. Treatment is based upon physiological properties, involving many therapies aside from simply opening the abdomen.
Wernicke encephalopathy
CONTENTS Rapid Reference 🚀 Pathophysiology Signs & Symptoms Risk factors Epidemiology Laboratory studies Imaging Differential diagnosis & securing the diagnosis Prevention Treatment Prognosis Related topics Metronidazole induced encephalopathy (MIE) Podcast Questions & discussion Pitfalls biochemistry Thiamine is a co-factor in numerous enzymatic reactions involved in energy metabolism, as shown below. Thiamine deficiency has consequences including […]
EMCrit 39 – Hyponatremia
Hmm… he’s tasty, but he just needs a little salt! In this podcast, I discuss the management of hyponatremia in the ED.
Lung cancer
CONTENTS Lung cancer screening Epidemiology Types of lung cancer NSCLC (non-small cell lung cancer) Adenocarcinoma Lepidic predominant adenocarcinoma Squamous cell carcinoma Large cell carcinoma Clinical presentation Management of NSCLC Staging Discussion of specific therapies: Radiotherapy Targeted therapy EGFR mutations ALK fusion gene Chemotherapy Integration of therapies to manage specific situations: Stage I-III: Surgery +/- adjuvant […]
Nonconvulsive Status Epilepticus (NCSE)
CONTENTS Definition of NCSE Epidemiology and causes of NCSE Various clinical presentations General clues to the diagnosis of NCSE Common differential diagnostic considerations EEG: Indications to obtain an EEG Duration of continuous EEG monitoring Antiepileptic trial for ictal/interictal continuum abnormalities Management of NCSE Subtypes of NCSE NCSE with coma Absence NCSE with onset in adulthood […]
Diuretics & Deresuscitation
CONTENTS Specific diuretics Acetazolamide SGLT2-inhibitors Loop diuretics Loop diuretic infusion Thiazides Amiloride (Spironolactone) General approach to diuresis in acute care medicine Intro Large-volume diuresis Diuretic resistance Hyperdiuresis Managing problems that arise during diuresis Hypernatremia Metabolic alkalosis Hypokalemia Rising creatinine [1] acetazolamide: dosing ⚠️ Diuretic tolerance often arises when acetazolamide is used for >48 hours. (37675009) […]
PulmCrit- Metabolic sepsis resuscitation: Strike hard, strike fast, no remorse
Escalation-deescalation There are roughly two strategies for adjusting the intensity of treatment: Titrated strategy: Treatment intensity is adjusted to match the severity of the disease. Escalation-deescalation strategy: Treatment intensity is increased rapidly to exceed disease severity and gain control of the disease. After the patient improves, treatment intensity is reduced. The best strategy depends on […]
Chronic obstructive pulmonary disease (COPD)
CONTENTS Definitions Epidemiology & risk factors Symptoms Clinical examination Laboratory evaluation PFTs in COPD Radiology: Hyperinflation on radiography Centrilobular emphysema Paraseptal emphysema Panlobular (panacinar) emphysema Chronic bronchitis Bronchiectasis-COPD overlap syndrome (BCOS) ➡️ Diagnosis of COPD Differential diagnosis Differentiation of asthma vs. COPD Disorders causing emphysema (without tobacco exposure) Management Integrated approach to COPD therapies (Inhalation […]
PulmCrit- Overcoming occult diuretic resistance: Achieving diuresis without dehydration
Critically ill patients often strongly retain sodium. This may cause diuresis attempts to fail, if patients excrete dilute urine leading to a loss of water without loss of sodium. Such patients may seem to respond to diuresis, but in fact they are merely becoming progressively dehydrated and hypernatremic (occult diuresis resistance).
EM Nerd-A Case of Shadows Continues
The use of point of care ultrasound (POCUS) in the Emergency Department is a Bayesian playground for those willing to indulge. Take for example the performance of POCUS in the diagnosis of pulmonary embolism (PE). The poor sensitivity of bedside echocardiography to identify all-comers with pulmonary embolism is well documented. Most series cite a sensitivity […]
Tick-borne illnesses
CONTENTS Rapid Reference 🚀 Overview Pathophysiology Diagnosis Epidemiology Presentation: Signs & symptoms Bottom line: key diagnostic clues Labs Neuroimaging Treatment Podcast Questions & discussion Pitfalls approach to critical illness possibly due to tick borne disease ✅ #1) when to suspect tick borne illness (more) (#1) Sepsis without a definite source of infection. (#2) Tick exposure […]
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