There has been a long-standing debate in the fields of emergency medicine and critical care regarding the ideal paralytic agent to use during RSI, rocuronium or succinylcholine. This dispute, has even developed slogans such as Roc Rocks, Sux Sucks as one side attempts to definitively proclaim its superiority through witty aspersions. But up until now […]
Search Results for: procedural sedation
Acute exacerbation of COPD (AECOPD)
CONTENTS Rapid Reference 🚀 Diagnosis & workup Key pathophysiologic concepts for management of COPD Basic treatments Noninvasive ventilatory strategies BiPAP is first line Difficulty tolerating BiPAP HFNC Monitoring on HFNC/BiPAP Indications for delayed intubation How long should BiPAP/HFNC be continued? Intubation and ventilator management Podcast Questions & discussion Pitfalls confirm diagnosis Review chest X-ray. Further […]
PulmCrit- Drowned Airway Algorithm: Cut to the chase
The literature describes various techniques for the drowned airway. However, there doesn’t appear to be any airway algorithm which integrates these into a coherent strategy. A collection of airway tricks without any plan is a formula for disaster.
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. […]
Noninvasive Respiratory Support
CONTENTS Rapid Reference 🚀 Groundwork: When noninvasive support is less useful Goals & assessment BiPAP & CPAP Interface Contraindications Diseases which respond very well Sedation to tolerate the mask Setting BiPAP in various situations Ventilators used to provide BiPAP or CPAP High flow nasal cannula (HFNC) Indications How to set HFNC Dirty HFNC Selecting which […]
CT Angiogram for evaluation of severe hematochezia
Introduction 0 Gastrointestinal hemorrhage is a common reason for ICU admission. The approach to severe upper GI bleeding is relatively straightforward (figure below). A predictable approach facilitates planning ahead, and anticipating who needs to be contacted for help when. 0 0 Unfortunately, the approach to severe hematochezia is often less clear. Below is a description […]
EMCrit – RACC Lit Review Oct/Nov 2022
Oct/Nov 2022
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 […]
Hyperthermia & heat stroke
CONTENTS Rapid Reference 🚀 Definition & diagnosis of hyperthermia Differential diagnosis Evaluation Treatment Sedation & Shivering tx Intubation if necessary Temperature control overview (1) Internal cooling: IV fluid (2) Surface cooling (3) Respiratory cooling Management of complications Podcast Questions & discussion Pitfalls what is hyperthermia? Fever is temperature elevation due to activity of the hypothalamus, […]
Line infection
CONTENTS Rapid Reference 🚀 Physiology Prevention Clinical features Diagnosis Management Overall strategy Empiric antibiotic selection Treatment duration Persistent bacteremia Specific situations Septic thrombophlebitis Arterial line infection Chest port infection Podcast Questions & discussion Pitfalls various mechanisms of infection: Early infections often arise from the skin: (a) These may occur during line insertion. (b) There may […]
Anaphylaxis
CONTENTS Rapid Reference 🚀 Diagnosis Clinical findings & definition Causes Differential diagnosis Investigation Anaphylaxis vs. bradykinin-mediated angioedema Treatment Source control Components of therapy Epinephrine IV epinephrine infusion Fluid resuscitation Antihistamines Steroid Inhaled beta-2 agonists Overall treatment strategy General treatment strategy Anaphylaxis in the beta-blocked patient Airway management Recovery phase & extubation Disposition Podcast Questions & […]
Pulmcrit- Evidence Update: Phenobarbital in Alcohol Withdrawal
Over the past year, the five papers below were published regarding the use of phenobarbital in alcohol withdrawal. These studies aren’t massive, glittering multicenter RCTs (and, realistically, it’s dubious whether such a study will happen). However, these papers bring some unique and interesting perspectives to the table. This post will summarize them briefly – a bit like a sampler flight of beers (figure above).
Acalculous cholecystitis
CONTENTS Basics Epidemiology Clinical presentation Differential diagnosis Investigations Labs Ultrasonography CT scan HIDA scan Overall diagnostic approach Treatment Podcast Questions & discussion Pitfalls overview Acalculous cholecystitis is defined as cholecystitis that occurs without a gallstone. This typically occurs in critically ill patients due to a combination of factors (e.g. bile stasis and hypoperfusion). Acalculous cholecystitis […]
Episode 10 – Surviving Sepsis Campaign (SSC) Guidelines 2012
SSC Guidelines 2012
2012 Surviving Sepsis Campaign Guidelines
2012 Surviving Sepsis Campaign Guidelines from my Practical Evidence Podcast
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