CONTENTS Rapid Reference 🚀 Introduction How to screw this up Approach to ischemia evaluation Step #1: should we check troponin? Step #2: does this troponin-positive patient have an MI? Step #3: type-1 versus type-2 MI? Treatment Type-1 MI Type-2 MI Unclear type-1 vs. type-2 MI Podcast Questions & discussion Pitfalls approach to ischemic evaluation for […]
Search Results for: aprv
Clostridioides (prev: clostridium) difficile
CONTENTS Rapid Reference – Management of severe C. Difficile 🚀 Prevention and C. Diff-o-genic antibiotics Presentation & diagnosis Lab testing Colonoscopy Imaging Risk-stratification Treatment Non-standard therapies Podcast Questions & discussion Pitfalls Checklist for management of severe C. Difficile ✅ Sepsis resuscitation 📖 Imaging (Abdominal X-ray +/- CT scan) 📖 Consider serial abdominal X-ray to follow […]
Anticholinergic intoxication
CONTENTS Anticholinergic agents Epidemiology Clinical presentation Differential diagnosis Evaluation Management Physostigmine Treatment of agitation Other management issues Management of combined anticholinergic & sodium channel blocker toxicity Podcast Questions & discussion Pitfalls There are hundreds of substances with anticholinergic activity. Below are some of the most common and notable. agents which function predominantly as anticholinergics Atropine. […]
GI Bleeding
CONTENTS Rapid Reference: Overview & Checklist 🚀 Investigations Diagnosis & bedside evaluation Risk stratification Resuscitation basics Causes Specific bleeding location/types Approach to upper GI bleed Variceal bleed Hematochezia and (presumed) lower GI bleed Podcast Questions & discussion Pitfalls history & physical History: NSAID use? Abdominal pain? Alcoholism? Liver disease? Surgical history: Gastric bypass surgery? AAA […]
Diagnosis of metabolic acid-base disorders
CONTENTS Rapid Reference 🚀 Getting started: metabolic vs. respiratory abnormalities The anion gap Diagnostic approach to metabolic pH abnormalities Respiratory pH analysis & how much will it help us? Basic principle: Diagnoses are more important than numbers Other approaches to pH analysis Podcast Questions & discussion Pitfalls diagnosis of metabolic acidosis/alkalosis: evaluating compensation: metabolic vs. […]
Delayed Sequence Intubation (DSI)
This page is a compilation of all things Delayed Sequence Intubation (DSI) The Delayed Sequence Intubation (DSI) Publication is in Ann Emerg Med 2014 and is currently available as FOAM (http://dx.doi.org/10.1016/j.annemergmed.2014.09.025) CJEM DSI Journal Club DSI is one of 4 things that I think need to be used for cutting edge airway management in the […]
Approach to beta-lactam allergy in critical care
CONTENTS Rapid Reference 🚀 Getting started Types of drug reaction Allergy history How allergies cause harm Basic science of beta-lactam allergy Techniques for allergy management Skin testing Graded challenge Desensitization General approach to beta-lactam allergy in critical care Groups of antibiotics with cross-allergy: Aminopenicillins & select G1-G2 cephalosporins Cefazolin Nafcillin Piperacillin-tazobactam Cefepime & most G3 […]
Necrotizing fasciitis
CONTENTS Basics Diagnosis Clinical presentation Laboratory abnormalities Ultrasonography Imaging Bedside surgical exploration Management Sepsis resuscitation Antibiotics Surgical debridement Therapy for simultaneous toxic shock syndrome Extra oxygen Podcast Questions & discussion Pitfalls general concept The fascia is a thin layer of connective tissue beneath the skin. Infection can spread rapidly along this fascial layer. Severe infection […]
The Sign of Four Part 2
On September 9th 2013 the article we have all been eagerly awaiting (or perhaps just myself!), was published in Circulation by Sarode et al (1). What was formerly known as Trial 3002 was officially named “Efficacy and Safety of a 4-factor Prothrombin Complex Concentrate in Patients on Vitamin K Antagonists Presenting with Major Bleeding”. Surprisingly […]
Status Epilepticus
CONTENTS Getting started: (1) Initial approach to status 🚀 (2) After the dust has settled 🚀 Causes Diagnosis & definition Definition of status epilepticus Seizure mimics Differentiation from pseudoseizure Treatment overview Initial treatment Benzodiazepine Hypoglycemia, hyponatremia, and thiamine deficiency Conventional antiseizure medication Neurolytic intubation Subsequent management NORSE Neuromonitoring Waking & weaning Supportive medical management Approach […]
Lymphoproliferative diseases
CONTENTS Pulmonary lymphoid neoplasms MALT lymphoma PP-DLBCL (Primary pulmonary diffuse large B-cell lymphoma) Lymphomatoid granulomatosis Pulmonary involvement from systemic lymphoma PTLD (posttransplant lymphoproliferative disorder) IgG4-related lung disease Pleural involvement ➡️ Benign hyperplastic disorders Follicular bronchiolitis (aka BALT hyperplasia) ➡️ GLILD (Granulomatous and lymphocytic interstitial pneumonia) ➡️ Questions & discussion abbreviations used in the pulmonary section: […]
Tuberculosis
CONTENTS Epidemiology & risk factors Clinicoradiologic forms Natural history of tuberculosis Primary pulmonary TB Tuberculous pleural effusion ➡️ Chronic tuberculous empyema ➡️ Healed tuberculosis (Ghon complex) Postprimary TB Miliary TB Acute miliary TB Subacute/chronic miliary TB Tracheobronchial involvement Laryngeal TB Diagnosis of active pulmonary TB: overview Red flags to consider the diagnosis of TB Initial […]
Unfractionated heparin (UFH), LMWH, fondaparinux, argatroban, and bivalirudin
CONTENTS Overview of indirect-acting anticoagulants (heparin & fondaparinux) Risk assessment Basic science – how these agents work Choice of agent Protamine for reversal of unfractionated or low molecular-weight heparin Unfractionated heparin (UFH) Dosing and monitoring of unfractionated heparin Pseudo-heparin resistance Heparin resistance Low molecular-weight heparin (LMWH) Various LMWH agents & dosing Enoxaparin dosing & monitoring: […]
Evidence for the Protocols
Evidence for Non-Invasive Protocol The paper that allowed us to start non-invasive protocols=gamechanger. [1. Jones AE, Shapiro NI, et al.; Emergency Medicine Shock Research Network (EMShockNet) Investigators. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010 Feb;303(8):739?46.] Is septic shock without lactate elevation as sick […]
Tick-borne illnesses
CONTENTS Rapid Reference 🚀 Overview Pathophysiology Diagnosis Epidemiology Presentation: Signs & symptoms Bottom line: key diagnostic clues Labs Neuroimaging Treatment Podcast Questions & discussion Pitfalls approach to critical illness possibly due to tick borne disease ✅ #1) when to suspect tick borne illness (more) (#1) Sepsis without a definite source of infection. (#2) Tick exposure […]
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