The HINTS exam is a 3-part test designed by Dr. Newman-Toker to clinically exclude a central cause of acute vertigo in patients who present with vertiginous symptoms. HINTS involves most famously, the head impulse test(see diagram below), a maneuver which involves torquing your patients head from midline to 20 degrees of rotation(or Vice Versa) and […]
Search Results for: mental toughness
Resuscitation Program and FEMinEM discussion on Women as Conference Speakers and Unconscious Bias
ART Program and FEMinEM Hangout
PulmCrit – Lupus Anticoagulant in COVID-19: Culprit or correlate?
An emerging body of evidence relates lupus anticoagulant to COVID-19. Both of these topics are enormously confusing on their own, so let’s try to ease into this… background on lupus anticoagulant what is lupus anticoagulant? Lupus anticoagulant isn’t any single thing, but instead it refers to a variety of different antibodies which may behave […]
EMCrit Wee – Follow-Up to the Ghali Grills Episode on APRV
More on yesterday’s APRV episode
Intracerebral hemorrhage (ICH)
CONTENTS Rapid Reference 🚀 Pathophysiology Causes of ICH Imaging Getting started – Which scans to order initially Noncontrast CT scan CT angiography +/- venography MRI Invasive angiography Treatment Airway management Anticoagulation reversal Blood pressure management Neurosurgical interventions Supratentorial hematoma evacuation Cerebellar hematoma Intraventricular hemorrhage & EVD Seizure monitoring & management Other supportive measures Prognostication Related […]
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 […]
EMCrit RACC – Analyzing Difficult Resuscitation Cases #1 from ResusMe
STEPUP for case analysis
“The Adventure of the Empty House”
Well before Han Solo was frozen in carbonite, before Sigourney Weaver crossed galaxies in cryostasis, or Walt Disney was cryopreserved, we have been fascinated by the stasis-like powers of hypothermia. Given this enthusiasm, we most likely would have reacted with just as much vigor even if the initial trials of hypothermia for out of hospital […]
Severe influenza
CONTENTS Rapid Reference 🚀 Clinical presentation Radiology Bacterial coinfection Diagnostic panel Treatment Resuscitation Antibiotics Anti-viral therapy Respiratory support Adjunctive therapy Virus-associated hemophagocytic syndrome (VAHS) Approach to treatment failure Extrapulmonary complications Virology of influenza Podcast Questions & Discussions Pitfalls severe influenza checklist ✅ diagnostic tests (more) Nares PCR for MRSA. Blood cultures. Sputum gram stain & […]
PulmCrit- All 2nd line conventional anti-epileptics are equally good… or equally bad?
The management of generalized convulsive status epilepticus remains in perpetual status controversius. There is consensus that the front-line agent should be a benzodiazepine, but little agreement beyond that. The much-awaited ESETT trial is a multi-center RCT comparing three anti-epileptic agents for ongoing status epilepticus (levetiracetam, fosphenytoin, and valproate). This trial will be the highest-quality evidence […]
Diffuse alveolar damage (DAD) & Acute Interstitial Pneumonia (AIP)
CONTENTS Basics Causes of ARDS ARDS due to DAD ARDS without DAD Clinical presentation Radiology Bronchoscopy Investigation Diagnosis Management Questions & discussion abbreviations used in the pulmonary section: ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AIP: Acute interstitial pneumonia (Hamman-Rich syndrome) 📖 ANA: Antinuclear antibody 📖 […]
“A Timely Reexamination of the Case of the Thirteen Watches”
-Doing the same thing over and over again and expecting different results Albert Einstein on Insanity- For a near decade now our mad dash to the cath lab has been based off flawed data and an illogical certainty that every moment of delay is detrimental to our patients. As such we were completely flabbergasted […]
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 […]
PulmCrit- Ultrasound-assisted thrombolysis of PE works. The question is, why?
Ultrasound-assisted catheter-directed thrombolysis is increasingly popular for submassive PE. Unfortunately, the actual mechanism of action of this therapy remains unclear.
PulmCrit- Alcohol Withdrawal: One order to sedate them all
I should do a formal retrospective cohort study on this, but I don’t have time. Fortunately, the ICU group at Northshore/Long Island Jewish has done exactly that.
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