SAH and Hypoxic Encephalopathy
Search Results for: septic shock
PulmCrit – Bad news for sepsis-3.0: qSOFA fails validation
Sepsis 3.0 replaced the SIRS criteria with a new risk-stratification tool, qSOFA. qSOFA was initially developed within the Sepsis-3 publication itself. Until now, qSOFA has never been validated. The value of qSOFA vs. SIRS remains controversial.
EMCrit 297 – EVARs, TEVARs, and Endoleaks – Oh My! with Ani Aydin
EVAR complications can be deadly. Learn how they present and how to work them up.
Traumatic Spinal Cord Injury (SCI)
CONTENTS Rapid Reference 🚀 Epidemiology Physiology Clinical presentation Evaluation of the injury Spinal shock Imaging Management Airway & breathing Blood pressure targets Dysautonomia: Neurogenic shock Vagal hyperactivity Autonomic dysreflexia Orthostatic hypotension Sphincter dysfunction DVT prophylaxis Steroid Surgery Podcast Questions & discussion Pitfalls common causes of spinal cord trauma (33896529) Motor vehicle collisions, especially among the […]
EMCrit 191 – Cardiac Arrest Update
Cardiac Arrest Update & the Syndromes of Arrest
Pulmonary alveolar proteinosis (PAP)
CONTENTS Basics Epidemiology Clinical presentation Radiology Bronchoscopy Laboratory studies Diagnosis Treatment Questions & discussion abbreviations used in the pulmonary section: 7 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid fast bacilli AIP: Acute interstitial pneumonia (Hamman-Rich syndrome) 📖 ANA: Antinuclear antibody 📖 ANCA: Antineutrophil cytoplasmic […]
Hypocalcemia
CONTENTS Signs & symptoms EKG findings Labs Etiology Investigation of cause Treatment Intravenous calcium for refractory shock Podcast Questions & discussion Pitfalls Clinical manifestations relate to both the magnitude and acuity of hypocalcemia. symptoms Neuromuscular excitation: Anxiety, delirium, depression, coma. Paresthesias (perioral & extremities). Muscle cramping (tetany, laryngospasm), weakness, myalgias. Seizure (generalized tonic-clonic, generalized absence, […]
PulmCrit Wee – MENDS2: Fentanyl or fentanyl for sedation in mechanically ventilated adults with sepsis
The MENDS2 trial was intended as a study comparing dexmedetomidine to propofol. However, the doses of these medications used in the study weren’t high enough to be impactful. In retrospect, the study may actually be an investigation of how clinicians approach the agitated intubated patient – potentially revealing an over-reliance on opioid infusions.
EMCrit 368 – The Acute Critical Care Medication Reconciliation with Josh Farkas
The acute crit care med rec
EMCrit Shadowboxing Case 4 – When to Pull the Trigger
When to pull the trigger…
Bradycardia
CONTENTS Clinical aspects Rapid Reference 🚀 Bradycardia is dangerous: physiology review Causes of bradycardia Sinus node dysfunction AV block General evaluation for the etiology ECG evaluation & subtypes of bradycardia Heart blocks 1st degree AV block Mobitz I (Wenkebach Block) Mobitz II 2:1 Block 3rd degree AV block Escape rhythms Junctional escape Ventricular escape Sinus […]
BRASH syndrome
CONTENTS Rapid Reference 🚀 Pathophysiology Epidemiology Clinical presentation Diagnosis & differential diagnosis Evaluation of the underlying cause Treatment overview Procedures & vascular access Volume management Bradycardia management Hyperkalemia management Advanced reversal agents for CCB/BBl Podcast Questions & discussion Pitfalls if hypovolemic, provide volume resuscitation: Bicarb <22 mM use isotonic bicarbonate. Bicarb >22 mM use lactated Ringers or […]
Approach to beta-lactam allergy in critical care
CONTENTS Rapid Reference 🚀 Getting started Types of drug reaction Allergy history How allergies cause harm Basic science of beta-lactam allergy Techniques for allergy management Skin testing Graded challenge Desensitization General approach to beta-lactam allergy in critical care Groups of antibiotics with cross-allergy: Aminopenicillins & select G1-G2 cephalosporins Cefazolin Nafcillin Piperacillin-tazobactam Cefepime & most G3 […]
Medication Reconciliation at ICU admission
CONTENTS Introduction Basic principles of medication reconciliation Specific medications: Cardiology Pulmonology Gastroenterology Hematology Endocrinology Neurology Transplantation Questions & discussion When a patient is admitted to the ICU, which of their outpatient medications should be continued? This is a rather mundane task, one which is often delegated to junior team members. However, these decisions can be […]
ECMO
CONTENTS basic management issues Circuit parameters Pump speed (RPMs) Flow (v) Pven (venous drainage pressure) Pint (internal pressure) Part (arterial, post-membrane pressure) ▵P (transmembrane) Sweep gas flow rate FdO2 SarO2 & ParO2 (arterial return sat & pO2) SvdO2 (venous drainage O2%) Low circuit flow & circuit flow arrest Pump failure Membrane lung dysfunction Air embolism […]
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