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 […]
Search Results for: mental toughness
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 334 – CV-EMCrit – Concise HeartMate 3 LVAD Overview
A review on dealing with HeartMate 3 (most common LVAD you will see) Emergencies
Bronchiolitis
CONTENTS Constrictive bronchiolitis: Bronchiolitis obliterans Epidemiology Clinical presentation Radiology Pulmonary function tests Bronchoscopy Diagnostic criteria Treatment DIPNECH (diffuse idiopathic pulmonary neuroendocrine cell hyperplasia) Cellular bronchiolitis: Aspiration bronchiolitis Diffuse panbronchiolitis Infectious bronchiolitis ➡️ RBILD (Respiratory bronchiolitis interstitial lung disease) ➡️ Follicular bronchiolitis ➡️ Questions & discussion abbreviations used in the pulmonary section: 2 ABPA: Allergic bronchopulmonary aspergillosis […]
PulmCrit: Algorithm for diagnosing ICP elevation with ocular sonography
Introduction with a clinical question A young woman is transferred to the ICU from an outside hospital due to severely depressed mental status, thought due to intoxication. You evaluate her intracranial pressure using ocular ultrasonography. Evaluation of the optic disc diameter in both eyes and in both orientations yields four measurements: 5.5 mm and 6.0 […]
EMCrit 325 – The Hypoxemic Difficult Airway and Preox Discussion with Jarrod Mosier
Hypoxemic patients will try to die on you…
PulmCrit- Why dialyze patients with chronic, asymptomatic hyperlithemia?
A patient with chronic asymptomatic hyperlithemia is tolerating their current lithium level well. If they have adequate renal function, their lithium level is very likely to decrease over time with hydration (and unlikely to increase). Why dialyze such a patient? It is impossible to improve a patient’s condition if the patient is already asymptomatic.
Cerebral venous thrombosis (CVT)
CONTENTS Pathophysiology Clinical features Epidemiology Signs & symptoms Relationship between thrombus location & clinical features Investigations Laboratory studies Imaging Treatment Neurologic deterioration despite treatment Prognosis Podcast Questions & discussion Pitfalls anatomy The superior sagittal and transverse sinuses are most frequently involved (in 60% of patients). The internal jugular and cortical veins are involved less often. […]
Pleuroparenchymal fibroelastosis (PPFE)
CONTENTS Basics Epidemiology Clinical presentation Radiology Differential diagnosis Diagnostic approach Management Prognosis 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 Bacillus AIP: Acute interstitial pneumonia (Hamman-Rich syndrome) 📖 ANA: Antinuclear antibody 📖 ANCA: Antineutrophil […]
NeuroEMCrit – Demystifying the EEG Report
EEGs are tougher than EKGs–but you can master the basics
EMCrit 144 – The PROPPR trial with John Holcomb
The biggest news in the management of traumatic hemorrhage is the PROPPR Trial. Want to hear from the lead author?
PulmCrit- Controlled aquaresis: Management of hypervolemic or euvolemic hyponatremia with oral urea
I’ve been yearning to use oral urea for euvolemic hyponatremia for years (e.g. see a post from 2015 here). Urea has been used in Europe for decades, but until very recently it was unavailable in the United States. It has numerous advantages compared to the vaptans (which are extremely expensive and potentially dangerous). Recently, an […]
PulmCrit: Which patients admitted for pneumonia need MRSA coverage?
Let’s be honest, our decisions to cover MRSA among patients admitted to the hospital with pneumonia are haphazard. It’s not our fault. The guidelines are contradictory. For example, the MRSA guidelines by the Infectious Disease Society of America recommend coverage for everyone admitted to the ICU with pneumonia. However, pneumonia guidelines by the same society recommend coverage only for patients with specific risk factors. Fortunately, new evidence and diagnostic tools may allow us to properly treat MRSA, without drowning the entire hospital in vancomycin.
The Adventure of the Red Circle
When it comes to non-traumatic intracranial hemorrhage (ICH) the onus of the emergency physician is diagnosis, while location and severity are of far less importance. Once the diagnosis is made and the initial stabilization complete, there is very little for us to do other then notify the ICU team and contact the neurosurgeon, who, in […]
Taking control of severe hyponatremia with DDAVP
. Introduction with a case . Imagine an elderly patient presenting with hypovolemic hyponatremia (sodium of 115 mM) and moderate confusion. How would you treat this patient? . The typical approach might be a slow infusion of 3% sodium chloride. The presence of neurologic symptoms supports the use of hypertonic saline. However, patients with hypovolemic […]
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