In this Mind of the Resuscitationist Episode, I discuss stop points: one for when you are using multiple vasopressors and especially about a cognitive stop point whenever things are going south.
Search Results for: septic shock
PulmCrit – Mythbusting 40 mg enoxaparin daily for DVT prophylaxis in critical illness
The basics often aren’t exciting, but it’s important to get them right. DVT prophylaxis is a good example of this. Most critically ill patients will receive DVT prophylaxis at some point during their ICU stay (that’s 5 million patients per year in the United States alone). Thus, even minor tweaks in the optimal treatment for […]
Submassive PE: Are we treating it backwards?
Introduction 0 Submassive PE can be challenging. Most patients do fine with heparin, but occasional patients suddenly arrest and others are left with longstanding pulmonary hypertension.1 Thrombolytics generally cause dramatic improvement, but may cause hemorrhage as well. Recent studies may seem to point in opposite directions. 0 Background: Heparin vs. Alteplase 0 Treatment centers around […]
Hypothermia
CONTENTS Rapid Reference 🚀 Definition & clinical consequences Evaluation Causes of hypothermia Initial investigations Management Rewarming Rewarming pulseless patient Rewarming patient with pulse General resuscitative measures Fluids & electrolytes Rhabdomyolysis & DIC Underlying problems: sepsis, hypothyroidism, adrenal insufficiency Podcast Questions & discussion Pitfalls Approach to hypothermia ✅ lab panel 📖 Fingerstick glucose (STAT). Basic labs […]
EMCrit RACC – Analyzing Difficult Resuscitation Cases #1 from ResusMe
STEPUP for case analysis
EMCrit 181 – Pulmonary Hypertension and Right Ventricular Failure with Susan Wilcox
Pulmonary Hypertension and Acute on Chronic RV Failure
EMCrit 161 – The New Fluid Assessment in Sepsis with Jean-Francois Lanctot
Fluids, Sepsis, Ultrasound, French-Canadian: what more do you want?
Post-MI complications
CONTENTS Approach to the deteriorating post-MI patient Re-infarction Post-MI pericarditis Bleeding & clotting: Retroperitoneal hematoma Left ventricular thrombus Mechanical complications Mitral valve chordae tendinae rupture Ventricular septal defect (VSD) Ventricular free wall rupture Tachyarrhythmia Atrial fibrillation or atrial flutter Ventricular arrhythmias PVCs Nonsustained VT Sustained monomorphic VT Polymorphic VT AIVR (accelerated idioventricular rhythm) Sinus tachycardia […]
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 […]
EMCrit 334 – CV-EMCrit – Concise HeartMate 3 LVAD Overview
A review on dealing with HeartMate 3 (most common LVAD you will see) Emergencies
Thrombocytopenia
CONTENTS Rapid Reference 🚀 Overview & definition Differentials Overall classification of thrombocytopenia in the ICU Clinical clues & specific situations Investigation of thrombocytopenia Platelet transfusion Additional comments on specific causes of thrombocytopenia: Drug-induced immune thrombocytopenia (D-ITP) Transfusion related thrombocytopenia Heparin-Induced Thrombocytopenia Podcast Questions & discussion Pitfalls approach to thrombocytopenia in critical illness ✅ investigations (more) […]
EMCrit 232 – SteelMan Debate – EMS Field Decisions in Cardiac Arrest with Howie Mell
Stay or Go with Cardiac Arrest in the Field?
The Case of the Precise Inaccuracy
In the world of medical science we are often lulled into a false sense of security by large sample sizes and their correspondingly small confidence intervals. We often forget that such methodologic strengths augment only a trials precision, or the likelihood a similar trial will produce similar results. Such statistical robustness speaks little towards a […]
EMCrit RACC-Lit Review for September 2022
All of the resuscitation and acute critical care goodness for Sept 2022
Traumatic Brain Injury (TBI)
CONTENTS Rapid Reference 🚀 Epidemiology Primary vs. secondary injury Glasgow Coma Scale (GCS) Initial evaluation Specific types of injury Diffuse axonal injury (DAI) Contusions & intraparenchymal hematomas Epidural hematoma Subdural hematoma Subarachnoid hemorrhage Intraventricular hemorrhage Cerebral venous sinus thrombosis Fat embolism Management Coagulation management Hemodynamic management ICP management Ventilator management Seizure prophylaxis & management DVT […]
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