CONTENTS Rapid Reference 🚀 Groundwork: When noninvasive support is less useful Goals & assessment BiPAP & CPAP Interface Contraindications Diseases which respond very well Sedation to tolerate the mask Setting BiPAP in various situations Ventilators used to provide BiPAP or CPAP High flow nasal cannula (HFNC) Indications How to set HFNC Dirty HFNC Selecting which […]
Search Results for: acid base
Anemia & transfusion targets
CONTENTS Rapid Reference – Approach to falling hemoglobin 🚀 Acute anemia: Physiology Causes Evaluation Gradual anemia: the ICU drift Transfusion targets for stable patients Managing Jehovah’s Witness patients Podcast Questions & discussion Pitfalls evaluation 📖 FAST exam if hemothorax or hemoperitoneum are suspected (e.g., s/p trauma – including CPR). Labs: Repeat complete blood count to […]
Superior vena cava syndrome (SVCS)
CONTENTS Causes Signs & symptoms Diagnosis: CT scan findings Grading system to define severity Management: Range of treatment options Management of critical SVC syndrome Pathophysiology & anatomy Questions & discussion abbreviations used in the pulmonary section: 5 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid […]
Thrombotic microangiopathies (including TTP, ST-HUS, and C-HUS)
CONTENTS Thrombotic Microangiopathy(TMA) Definition of TMA Causes of TMA Investigating the cause of TMA Initial empiric therapy for TMA Thrombotic thrombocytopenic purpura (TTP) Epidemiology of acquired TTP Clinical presentation of TTP Initial treatment of acquired TTP Shiga-Toxin mediated Hemolytic Uremic Syndrome (ST-HUS) Epidemiology & presentation of ST-HUS Diagnosis of ST-HUS Treatment of ST-HUS Complement-mediated Hemolytic […]
Endocarditis
CONTENTS Rapid Reference 🚀 Diagnosis When to suspect endocarditis Lab workup Septic pulmonary emboli Echocardiography (TTE vs TEE) Diagnostic strategies & criteria European Society of Cardiology criteria Manifestations include: Metastatic infection Neurologic complications Septic embolic encephalitis Antibiotics Empiric therapy Definitive therapy Methicillin-sensitive Staph. 📖 Methicillin-resistant Staph. 📖 Enterococcus. 📖 Streptococcus pneumoniae. 📖 Beta-hemolytic Streptococci. 📖 […]
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 […]
ARDS
CONTENTS Rapid Reference 🚀 Diagnosis of ARDS Definition of ARDS Cardiogenic pulmonary edema vs. ARDS Why is the patient in ARDS? Common causes of ARDS Evaluating the cause of ARDS ARDS pathophysiology: Intrapulmonary shunting Treatment: Basics Treating the cause of ARDS Steroid Conservative fluid strategy Treatment: Non-intubated patient High-flow nasal cannula & CPAP/BiPAP Awake proning […]
Thoracic radiology – Lymphadenopathy
CONTENTS Identification: Lymphadenopathy on chest radiography Lymphadenopathy on CT scan Causes of mediastinal and/or hilar lymphadenopathy Characterization of lymph nodes Calcified lymph node Low-attenuation lymph node High-attenuation lymph node Approach to thoracic lymphadenopathy Lymphadenopathy due to specific disorders Sarcoidosis Tuberculosis Questions & discussion hilar lymphadenopathy Hilar enlargement. Abnormal hilar contours. widened paratracheal stripe Normally, the […]
COMM CHECK: More On Resuscitation Communication
If the words of command are not clear and distinct, if the orders are not thoroughly understood, the general is to blame – Sun Tzu Communication During Resuscitation Communication continues to be a major issue in virtually all high-stress, time-sensitive environments. This has been discussed a number of times on EMCrit, most recently in […]
The Man with the Twisted Lip
As an Emergency Medicine doctor we are trained to function in varying degrees of uncertainty. We work in a world of risk of benefits vs harms. When the benefit to harm ratio reaches a threshold for action we are taught to do so swiftly and decisively. Given this, […]
Evidence for the Protocols
Evidence for Non-Invasive Protocol The paper that allowed us to start non-invasive protocols=gamechanger. [1. Jones AE, Shapiro NI, et al.; Emergency Medicine Shock Research Network (EMShockNet) Investigators. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010 Feb;303(8):739?46.] Is septic shock without lactate elevation as sick […]
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