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. […]
Search Results for: asthma
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 & […]
Atelectasis
CONTENTS Basics Clinical presentation Types and causes of atelectasis Radiology Right upper lobe Right middle lobe Right middle lobe syndrome Left upper lobe Lower lobe atelectasis Bronchoscopy Management Additional/related topics Round atelectasis Drowned lung Questions & discussion abbreviations used in the pulmonary section: 6 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 […]
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 […]
Acute colonic pseudo-obstruction (Oglivie’s syndrome)
CONTENTS Basics Clinical presentation Differential diagnosis Evaluation Causes Approach & management Podcast Questions & discussion Pitfalls definition Acute colonic pseudo-obstruction refers to a paralytic ileus of the colon which causes severe colonic dilation. In some cases the small bowel may also be involved. This is not due to anatomic obstruction, but rather due to hypomotility. […]
Dynamic left ventricular outflow tract obstruction (LVOTO)
CONTENTS Introduction Physiology Epidemiology Clinical findings Echocardiographic diagnosis Management Esmolol Podcast Questions & discussion Pitfalls Supplemental Media Dynamic left ventricular outflow tract obstruction (LVOTO) creates a confusing hemodynamic picture. If unrecognized, LVOTO will fail to respond to standard hemodynamic therapies. Indeed, LVOTO will often respond to various interventions in the opposite fashion than might be […]
EMCrit 371 – Iodinated Contrast Issues: Part 2 – Contrast Reactions
Continuing on our contrast issues theme…
Angioedema
CONTENTS Rapid reference 🚀 Overview Diagnosis of angioedema Histamine-mediated vs bradykinin-mediated angioedema Airway management Histamine-mediated angioedema Bradykinin-mediated angioedema Pathophysiology Differential diagnosis Evaluation Treatment Extubating the angioedema patient Podcast Questions & discussion Pitfalls allergic vs. bradykinin-mediated angioedema: approach to angioedema: Angioedema is a common indication for critical care admission. An allergist usually won’t be immediately available, […]
Top 10 reasons to stop cooling to 33C
Introduction 0 Following the Nielsen study, many hospitals developed two protocols for temperature management after cardiac arrest (33C or 36C). For example, the 36C protocol could be used for patients with contraindications to hypothermia (33C). With ongoing evidence emerging about hypothermia, many hospitals are abandoning their 33C protocols and using 36C for all post-arrest patients. […]
Hypertensive emergency
CONTENTS Background Use the MAP Pathophysiology of malignant hypertension (1) Is there a known cause of the HTN? (2) Is this actually a hypertensive emergency? (3) Re-evaluation for an underlying cause of the HTN. (4) Control Bp with IV antihypertensive agents. Nicardipine Clevidipine IV Labetalol (Medications to avoid) (5) Transition to oral antihypertensives. Calcium channel […]
Cystic Fibrosis pulmonary exacerbation
CONTENTS Definition of a CF respiratory exacerbation Evaluation of respiratory deterioration in CF Management CFTR-directed therapies Antibiotic therapy Airway clearance Bronchodilator Respiratory support (HFNC, NIV, intubation) Nutritional support Bowel regimen Glycemic control Physical therapy (Steroid not indicated) Other topics related to CF Hemoptysis in CF Pneumothorax in CF Cirrhosis in CF Burkholderia cepacia complex Nontuberculous […]
Medication Reconciliation at ICU admission
CONTENTS Introduction Basic principles of medication reconciliation Specific medications: Cardiology Pulmonology Gastroenterology Hematology Endocrinology Neurology Transplantation Questions & discussion When a patient is admitted to the ICU, which of their outpatient medications should be continued? This is a rather mundane task, one which is often delegated to junior team members. However, these decisions can be […]
The Problem of Thor Bridge
Disclosure: This post is unusually full of hearsay and conjecture. Like a secondary endpoint that flirts with statistical significance it should be viewed purely as hypothesis generating. For a more reasoned and experienced view of the following data please read Josh Farkas’s wonderful post on pulmcrit.org. Damage control ventilation is not a novel concept. It functions […]
Pulmonary alveolar proteinosis (PAP)
CONTENTS Basics Epidemiology Clinical presentation Radiology Bronchoscopy Laboratory studies Diagnosis Treatment Questions & discussion abbreviations used in the pulmonary section: 7 ABPA: Allergic bronchopulmonary aspergillosis 📖 AE-ILD: Acute exacerbation of ILD 📖 AEP: Acute eosinophilic pneumonia 📖 AFB: Acid fast bacilli AIP: Acute interstitial pneumonia (Hamman-Rich syndrome) 📖 ANA: Antinuclear antibody 📖 ANCA: Antineutrophil cytoplasmic […]
EMCrit 368 – The Acute Critical Care Medication Reconciliation with Josh Farkas
The acute crit care med rec
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