Tension pneumothorax is actually 2 diseases
PulmCrit- Why most diagnostic procedures aren’t beneficial
We often assume that diagnostic procedures will help patients. A lot of training goes into learning how to do these procedures. Procedures are dramatic. We like performing them. Patients are impressed, perceiving that we are “doing” something for them. Everything is awesome.However, when strict evidence-based medicine is applied to procedures, they are often less impressive.
IBCC chapter: VT storm
VT storm refers to recurrent episodes of VT/VF. Although any individual episode of VT can be broken, the overall process of recurrent arrests (or ICD shocks) creates a vicious cycle. Aggressive management is required with intubation, deep sedation, antiarrhythmics, and sympatholysis. Given the rarity of this condition, it’s difficult to obtain high-level evidence or extensive experience.
EMCrit 244 – Incredibly Important Wrinkles to Titrated Vasopressors during CPR in Cardiac Arrest with PO Berve
We’ve been doing it all wrong–mysteries solved thanks to PO Berve
IBCC chapter & cast: Metformin-induced lactic acidosis, et al.
Metformin poisoning and lactic acidosis has always been murky. For years there was debate about whether metformin-induced lactic acidosis exists (short answer: it obviously does). However, for an individual patient, it can still be confusing sorting out the contribution of metformin to their critical illness. A recent re-definition of the condition clarifies things a bit, but substantial confusion persists regarding how to diagnose and treat these patients.
PulmCrit- Extracorporeal CO2 removal: Putting the cart ahead of the horse?
Recently the concept of extracorporeal CO2 removal has become somewhat popular, with a goal of facilitating ultra low-tidal volume ventilation. Might there be other means to achieve the same goal? Let’s start with some basic concepts of mechanical ventilation… Fundamental unanswered questions Permissive hypercapnia refers to the concept of allowing the pCO2 level to increase […]
IBCC chapter & cast: Allergies to beta-lactam antibiotics
Emerging evidence shows that there is no such thing as a “penicillin allergy” or “cephalosporin allergy.” Instead, cross-allergic reactions are restricted to much smaller groups of antibiotics that share greater structural similarity. This opens the door to using beta-lactam antibiotics safely in patients who have had an allergic reaction to one or more of these drugs.
EMCrit 243 – The COACT Trial on Early vs. Delayed Cath after Cardiac Arrest without STEMI
New evidence on who needs to go to lab after cardiac arrest
IBCC chapter & cast: Preeclampsia & HELLP syndrome
Preeclampsia is among the most commonly encountered obstetric emergencies. Definitions and optimal therapies have changed significantly over the past few years. Although specialists in Obstetrics will invariably be involved in these cases, all resuscitationists need to have a firm grasp of this topic. The optimal therapies for preeclampsia remain controversial. For example, the International Society […]
PulmCrit- Nucleic acid microarrays streamline bacteremia management
Verigene is a nucleic acid micro-array which can be used to provide rapid information about positive blood cultures. The array detects genetic information which may reveal the genus/species of bacteria and the presence of various resistance genes.
IBCC chapter & cast: Hypertensive emergencies
Hypertensive emergency is a fairly common cause of ICU admission. Surprisingly little high-quality data is available to guide our management of these patients (e.g. optimal Bp target? ideal rate of reduction? need for arterial line?). This chapter describes a reasonable strategy to these patients, focusing on the pharmacokinetics of various antihypertensives.
EM Nerd-The Case of the Irregular Irregularity Continues
Very little about the management of atrial fibrillation is an emergency. And yet we in the Emergency Medicine community have embraced it as such. We gleefully bring to bear the full technological powers available to an Emergency Physician in our attempts to tame its irregular irregularity. Using this aggressive approach, we have proven ourselves quite […]
IBCC chapter & cast: Abdominal Compartment Syndrome
Abdominal compartment syndrome can result from primary abdominal pathology (e.g. bowel obstruction), but it can also occur due to systemic inflammation combined with large-volume resuscitation. As such, abdominal compartment syndrome is probably more frequent than generally perceived, functioning as an occult driver of multi-organ failure. Treatment is based upon physiological properties, involving many therapies aside from simply opening the abdomen.
EM Nerd-The Case of the Conspicuous Conclusion
The process of rapid sequence induction (RSI) often forces the clinician to choose between two conflicting priorities. Torn between maintaining a safe level of oxygen, rendering the patient apneic, and limiting the amount of positive pressure ventilatory support given prior to obtaining a secure airway in the hopes of minimizing the risk of aspiration. Traditionally […]
PulmCrit- DEXACET: Four grams of acetaminophen a day keeps the delirium away?
For decades, acetaminophen has been regarded as the first rung of the analgesic ladder. It has a nearly unparalleled risk/benefit profile when dosed correctly (it’s not tremendously effective, but it is extraordinarily safe). Theoretically, acetaminophen should be used very broadly among critically ill patients with pain.However, this isn’t the case.
- « Previous Page
- 1
- …
- 33
- 34
- 35
- 36
- 37
- …
- 92
- Next Page »