The RECOVERY trial just released a preprint demonstrating benefit from tocilizumab in COVID-19. As with the prior RECOVERY studies, this is a multicenter, open-label, pragmatic trial. A robust mortality benefit was detected (the fragility index calculates to 17, which isn’t too shabby). Several important secondary endpoints were positive as well (e.g., reduced intubation rate, reduced […]
Search Results for: acid base
EMCrit 266 – High Sensitivity Troponins with Louise Cullen
High Sensitivity Troponins are coming
Pericardial tamponade
CONTENTS Rapid Reference 🚀 Causes of tamponade Symptoms Physical exam Pulsus paradoxus Kussmaul’s sign EKG Radiology Echocardiography Diagnosis: Overall approach Low pressure tamponade Management Initial stabilization measures Ultrasound-guided pericardial drainage Interventional radiology or surgical drainage Tamponade patient in cardiac arrest Finer points: Limitations of this chapter Physiology Podcast Questions & discussion Pitfalls Key tests to […]
PulmCrit- Why we fail at hemodynamics: The flaw of averages & the swan’s curse
With a resurgence of the Swan, a resident recently asked me: why don’t we use the Swan to guide sepsis resuscitation? Answering this question forced me to recognize that many problems with the Swan continue to haunt us today when using our new darling, bedside echocardiography.
EMCrit 300 – Airway Continuous Quality Improvement and the Resus Airway Bundle
If you are not measuring your success, it probably is not that great
Confounding Questions in Resus – When is it safe to Perform an LP with Anti-Platelet Agents on Board
Can you tap a patient taking anti-platelet agents? CQiR:
EMCrit 131 – Cricothyrotomy – Cut to Air: Emergency Surgical Airway
Comprehensive information of surgical airway, cricothyrotomy, and the bougie cric
PulmCrit – Preview of Lopinavir/Ritonavir efficacy in COVID-19?
background Lopinavir/Ritonavir (tradename KALETRA) is a combination of protease inhibitors typically used in HIV, including post-exposure prophylaxis (lopinavir is the actual antiviral agent, with ritonavir functioning to inhibit metabolism of lopinavir, thereby boosting levels of lopinavir). In vitro, Lopinavir/Ritonavir has activity against SARS-CoV-1 and functions synergistically with ribavirin (the addition of ribavirin increases Lopinavir’s potency […]
Toxic Shock Syndrome (TSS)
CONTENTS Rapid Reference 🚀 Epidemiology Clinical presentation Lab tests Diagnosis Differential diagnosis Overall approach to diagnosis Treatment Basic sepsis resuscitation Antibiotics Source control Intravenous immunoglobulin (IVIG) Purpura fulminans Pathophysiology Podcast Questions & discussion Pitfalls diagnostic studies Basic labs (CBC with differential, electrolytes, liver function tests). DIC labs (PT, INR, fibrinogen, D-dimer). Creatine Kinase. Blood cultures, […]
EMCrit 361 – Life Threatening Tox and Toxicologic Cardiac Arrests from the AHA
AHA Guidelines on Critical Care Toxicology
EM Nerd-The Case of the Elemental Truancy
Much has been written regarding the benefits of apneic oxygenation. The physiological underpinnings are sound with minimal logistical and resource based costs. As such it has enjoyed widespread adoption throughout the Emergency Medicine and Critical Care world. Despite its popularity, the evidence supporting its use has been less inspirational. Recently, a meta-analysis published in Annals […]
Asbestosis, pneumoconiosis, and related disorders
CONTENTS Asbestos Asbestos interstitial lung disease (asbestosis) Benign asbestos pleural effusion (BAPE) ➡️ Pleural plaques Diffuse pleural thickening Mesothelioma Silicosis Coal workers pneumoconiosis Berylliosis Talcosis Intravenous talcosis Inhalational talcosis Silicone embolism syndrome Questions & discussion abbreviations used in the pulmonary section: 8 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute […]
Hypersensitivity pneumonitis (HP)
CONTENTS Basics Epidemiology Causative agents History Symptoms Laboratory evaluation Thoracic radiology Acute HP Nonfibrotic (subacute) HP Fibrotic HP Bronchoscopy Lung biopsy Differential diagnosis Diagnostic approach Treatment Questions & discussion abbreviations used in the pulmonary section: 1 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid Fast […]
About Mike Lauria
Mike Lauria Mike started working in emergency services in 2002 as a Firefighter/EMT-I. In 2005, he graduated from Dartmouth College with a degree in Physical Biochemistry and Spanish. After leaving Dartmouth, he enlisted in the Air Force, completed the rigorous Pararescue (PJ) training pipeline, and served at the 321st Special Tactics Squadron, RAF Mildenhall, UK, […]
Demystifying the p-value
Introduction 0 The limitations of p-values for null hypothesis testing has been debated since their invention in the 1920s. Unfortunately, statistics textbooks typically whitewash this controversy, presenting null hypothesis testing as the only viable approach to statistics. Recently, the journal of Basic and Applied Social Psychology took this debate a step further, officially banning the […]
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