CONTENTS Rapid reference: Approach to PFT interpretation 🚀 Approach to spirometry Approach to lung volumes About pulmonary function tests (PFTs) Contraindications to PFTs Brief discussion of commonly utilized tests Obstruction Large airway obstruction Restriction Nonspecific ventilatory limitation PRISM (preserved ratio impaired spirometry) DLCO Bronchial responsiveness: Bronchodilator response Methacholine bronchoprovocation Neuromuscular weakness & inspiratory pressures Changes […]
Search Results for: mental toughness
PulmCrit- Can we fix a broken circadian clock with melatonin?
Circadian rhythms and melatonin are best known for their relationship to sleep. However, they have a much broader range of functions. Circadian rhythms cause many organs to enter a resting state at night (e.g. heart rate decreases, cortisol levels increase).
PulmCrit: A-lines in septic shock: the wrist versus the groin
Historically, emphasis has rested on the distinction between noninvasive versus invasive BP (e.g., cuff pressure vs. radial arterial pressure). Attention focused on whether noninvasive oscillometric BP monitoring is adequate. Meanwhile, it has been assumed that all invasive BP measurement sites are created equal.
Anticoagulant reversal
CONTENTS General considerations Approach to warfarin reversal Urgent reversal Non-urgent supratherapeutic INR Approach to DOAC reversal Dabigatran Factor Xa inhibitors (riveroXABAN, apiXABAN, edoXABAN, fondaparinux) Reversal of other agents Thrombolytics (e.g. tPA) Heparin reversal Antiplatelet agent reversal Pharmacology of broad-spectrum reversal agents Fresh Frozen Plasma (FFP) Prothrombin Complex Concentrate (PCC) Factor IX Complex DDAVP Tranexamic acid […]
PulmCrit- How to convert a VBG into an ABG
This post is about a research project I did as a pulmonary critical care fellow in 2011. To understand it, you need to know a bit of the story behind it.
Pneumothorax and bronchopleural fistula (BPF)
CONTENTS Definitions & classifications Symptoms Signs Radiology: POCUS for diagnosis and monitoring Chest radiograph Signs of pneumothorax Size determination CT scan Causes of pneumothorax Management of various situations: Primary spontaneous pneumothorax Secondary spontaneous pneumothorax Indications for pleurodesis Management of persistent air leak Traumatic pneumothorax (including iatrogenic) Tension pneumothorax Oxygen to encourage nitrogen reabsorption? Pigtail versus […]
The Case of the Thirteen Watches
Door-to-balloon time is probably the most overstated, but least understood surrogate outcome measured in Emergency Medicine today. No sooner does the patient with midsternal chest pressure and ST elevations set foot in the emergency department, when they are packaged up and swept away to the cath lab by a gang of cardiology fellows and attendings. Now with […]
EMCrit 326 – NeuroEMCrit – 2022 Spontaneous Intracerebral Hemorrhage (ICH) Guidelines with Casey & Neha
NeuroEMCrit dissects the new ASA sICH Guidelines
Brief Review of the King Vision Video Laryngoscope
Minh Le Cong, retrieval physician extraordinaire, shares a review of the King Vision Video Laryngoscope.
EMDOCS.net hosted me on Ask Me Anything
EMDOCS.net brought me on for an AMA session
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.
The Sign of Four…
…Factors that is. On April 23rd 2013, the FDA approved CSL Behring’s product Kcentra as the first 4-Factor Prothrombin Complex Concentrate (PCC) available in the United States for the use in treatment of anti-coagulated patients with acute hemorrhage. 4- Factor PCC has been widely available in Europe and Canada for years, but the FDA wanted […]
PulmCrit- Is Lopinavir/Ritonavir down and out?
A lot has happened since the last post on Lopinavir/Ritonavir (it was only March 4, but it seems like a year ago). Here is a quick reminder of where we left off: Lopinavir/ritonavir (tradename KALETRA) is a combination of protease inhibitors used in HIV, which might also be effective in COVID-19. Prior studies on SARS […]
EMCrit 312 – Tube Thoracostomy (Chest Tubes) Part 1 Peri-procedural Chest Tube Stuff
You need to understand and be able to perform perfectly in the rare circumstances that still demand chest tubes
NeuroEMCrit – 31 #NeuroPostItPearls
A multiplicity of neuro tips
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