Proning is one of the only evidence-based techniques to affect the mortality of ARDS patients. I’ve been wanting to do an episode on proning for a while.
Search Results for: ecmo
PulmCrit Wee – Prophylactic antibiotics after cardiac arrest?
background Pneumonia after cardiac arrest is problematic for several reasons: Many patients aspirate during cardiac arrest. Patients are intubated and mechanically ventilated, usually with poor mental status – conditions which do not promote secretion clearance. Early diagnosis of pneumonia is impossible for many reasons (inability to measure a fever due to therapeutic temperature monitoring, inability […]
EMCrit 259 – Cardiogenic Shock — The Next Level & Mechanical Circulatory Support with Jenelle Badulak
Taking Cardiogenic Shock Management to the next level…
Local Anesthetic Systemic Toxicity (LAST)
CONTENTS Epidemiology Presentation Differential diagnosis Treatment Podcast Questions & discussion Pitfalls patient-dependent risk factors Hepatic dysfunction: Most anesthetics are hepatically cleared. Clearance rate is most relevant if the agent is slowly absorbed, administered in multiple doses, or provided as a continuous infusion. Cardiac dysfunction: Reduced cardiac reserve function may render LAST more dangerous (e.g., patients […]
IBCC – ARDS
There probably isn’t much to say about ARDS that hasn’t been said in some form within the past couple years. We’ve debated continually about the optimal approach to this syndrome, in the absence of much solid evidence (the only large, multi-center RCT which has been replicated in ARDS was ACURASYS – and it failed to […]
IBCC chapter & cast – Submassive & Massive PE
PE is the third leading cause of vascular mortality, after myocardial infarction and stroke. It is an enormously heterogeneous and unpredictable disease, which makes treatment difficult. As such, it should not be surprising that PE therapy remains highly controversial. For example, the new European Society of Cardiology guidelines recommend anticoagulation and watchful waiting for high-risk […]
Bupropion intoxication
CONTENTS Overview Pharmacodynamics Pharmacokinetics Diagnostics & doses Clinical evolution Treatment Activated Charcoal Whole bowel irrigation Neurotoxicity management Cardiotoxicity management Podcast Questions & discussion Pitfalls Bupropion is increasingly used for several indications (depression, tobacco cessation, and ADHD). Unfortunately, it is also a uniquely dangerous and increasingly common source of intoxication (especially the extended-release formulations). For example, […]
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 […]
Calcium Channel Blocker (CCB) & Beta-Blocker (BBl) overdose
CONTENTS Clinical presentation Differential diagnosis & evaluation Tier-1 therapies Decontamination Airway control & vascular access Basic hemodynamic interventions Glucagon or milrinone IV calcium Atropine Hyperinsulinemic euglycemia Tier-2 therapies Methylene blue ECMO Hemodialysis Transvenous pacemaker Intralipid Other issues that may require treatment Hypoglycemia Sodium channel blockade Potassium channel blockade Podcast Questions & discussion Pitfalls general Onset […]
RACC Lit Review – Feb 2024
RACC Lit Review for Feb 2024
EMCrit 69 – The Future of CPR with Keith Lurie and Demetris Yannopoulos
Drs. Keith Lurie and Demetris Yannopoulos elaborate on the future of CPR
Submassive & Massive PE
CONTENTS Most useful material: Crashing patient: Massive PE resuscitation guide 🚀 General approach to (sub)massive PE: (#1) Investigation package (#2) Risk stratification (#3) Thrombolytic contraindications (#4) Treatment approach Resuscitation of massive PE Avoid procedures if possible Fluid management Inotropes & vasopressors Inhaled pulmonary vasodilator(s) Hematologic management: Anticoagulation (heparin) Thrombolysis Regimens: Full dose Half dose Quarter […]
EMCrit 150 – A Look Back
Can’t believe we made it this far…and it’s all thanks to the emcritters!
adrenal insufficiency revealed by NLR
Case puzzler: A patient was admitted to ICU due to profound hypotension of unknown cause. What *two* clues are contained in the CBC which reveal the diagnosis? Answer In isolation, this data wouldn’t be very exciting. However, there are two things which are strange about this CBC in the context of a shocked patient. Clue […]
EMCrit 77 – Left Ventricular Assist Devices (LVADS)
LVADs are complicated especially when the patient starts going downhill. Zack Shinar is going to attempt to make it a bit easier.
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