SALAD Airway Decontamination
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Five pearls for the dyspneic patient with Guillain-Barre Syndrome or Myasthenia Gravis
0 Introduction 0 Guillain-Barre Syndrome (GBS) and Myasthenia Gravis (MG) are common causes of acute weakness. About 25% of these patients may develop respiratory failure requiring intubation, so a major concern is determining who requires ICU-level monitoring and whether intubation should be performed. Ideally it would be possible to predict with 100% accuracy which patients […]
Guide to APRV for COVID
CONTENTS Preamble Parameters Initial settings Monitoring Troubleshooting hypoxemia & acidemia Weaning Weaning initiation Spontaneous Breathing Trial & Extubation pathways Questions & discussion Pitfalls APRV can be a bit scary for folks who aren’t used to it. Everyone has slightly different ways of setting the parameters. However, over time I’ve come to believe that APRV is […]
EMCrit 344 – Sleep for the Weary II – General Sleep Stuff
All things Sleep–you will add years to your life if you sleep well, so the time investment to listen to this podcast may be well worth it
CV-EMCrit Wee – MCS Minute: ECMO and the DO2/VO2 ratio with Trina Augustin
The first MCS Minute
You Don’t Understand the Osm Gap – Guest Post by Rory Spiegel
Think you understand the Osm Gap–you don’t
Myasthenia gravis & myasthenic crisis
CONTENTS Rapid Reference 🚀 Myasthenia Gravis: Background information Pathophysiology Presentation Diagnosis Serologic testing & types Drugs to avoid in myasthenia gravis Myasthenic crisis: diagnosis Diagnosis of myasthenic crisis: basics Differentiation from cholinergic crisis Triggers of myasthenic crisis Myasthenic crisis: treatment Blood gas monitoring Bedside pulmonary function tests Respiratory support Nutrition & GI access Pyridostigmine Steroid […]
Valproic Acid Intoxication
CONTENTS Rapid Reference 🚀 Pharmacology & pathophysiology Clinical manifestations Laboratory tests Imaging Treatment General supportive measures Gastrointestinal decontamination Naloxone Carnitine Hemodialysis Carbapenems Additional treatments for hyperammonemia Serial re-assessment For patients on valproate to manage epilepsy Podcast Questions & discussion Pitfalls formulations and absorption Valproic acid is available in immediate-release, delayed-release (q12-hr administration) or extended-release (q24-hr […]
Paroxysmal sympathetic hyperactivity (PSH)
CONTENTS Introduction Epidemiology Clinical findings Differential diagnosis Approach to the diagnosis Treatment Supportive care Medical therapy overview Abortive therapy Preventative therapy Podcast Questions & discussion Pitfalls basics Paroxysmal sympathetic hyperactivity (PSH) is a pattern of recurrent bursts of dysregulated sympathetic activity, resulting from severe brain injury. These episodes of sympathetic activation are short, dramatic, and […]
Hypersensitivity pneumonitis (HP)
CONTENTS Basics Epidemiology Causative agents History Symptoms Laboratory evaluation Thoracic radiology Acute HP Nonfibrotic (subacute) HP Fibrotic HP Bronchoscopy Lung biopsy Differential diagnosis Diagnostic approach Treatment Questions & discussion abbreviations used in the pulmonary section: 1 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid Fast […]
NeuroEMCrit – The Perils of the ICH Score
Don’t use the ICH score in isolation to not give aggressive critical care…
Alcohol withdrawal
CONTENTS Rapid Reference 🚀 Preamble & disclaimer Diagnosis Alcohol withdrawal vs. hepatic encephalopathy Therapeutic target (CIWA vs RASS) Treatment: Phenobarbital monotherapy Phenobarbital pharmacology Advantages of phenobarbital over benzodiazepines Contraindications to phenobarbital ➡️ Phenobarbital guideline Checking phenobarbital levels? ➡️ Pitfalls of phenobarbital Alternative agents Benzodiazepines Valproic acid Antipsychotics & alpha-2 agonists (dexmedetomidine, clonidine, guanfacine) Ketamine Other […]
EMCrit 191 – Cardiac Arrest Update
Cardiac Arrest Update & the Syndromes of Arrest
Pulmonary arteriovenous malformations (PAVMs) & other rare pulmonary vascular disorders
CONTENTS Basics Epidemiology Symptoms Radiology of PAVMs Diagnosis of HHT (hereditary hemorrhagic telangiectasia) Management Management of PAVMs Management of HHT (hereditary hemorrhagic telangiectasia) Other rare pulmonary vascular disorders: Pulmonary artery aneurysms & pseudoaneurysms Pulmonary vein thrombosis/occlusion Platypnea-orthodeoxia syndrome Questions & discussion abbreviations used in the pulmonary section: 8 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute […]
Acute Pancreatitis (including hypertriglyceridemic pancreatitis)
CONTENTS Rapid Reference 🚀 Diagnosis Clinical findings Laboratory studies (lipase) Radiology Diagnostic criteria Evaluating the cause of pancreatitis Risk stratification – who needs ICU? Treatment General principle: pancreatoseptic equivalence Treatment of causative factors ERCP? Resuscitation Analgesia Nutrition Non-hypertriglyceridemic pancreatitis Hypertriglyceridemic pancreatitis Prophylactic & early antibiotics Fluid collections & infected necrosis Abdominal compartment syndrome Hemorrhage Hypertriglyceridemic […]
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