0 Clinical Question 0 A patient is admitted status post ischemic stroke with focal edema on CT scan. There is no concern regarding herniation. Is there a role for continuous infusion of hypertonic saline with a goal of maintaining a sustained elevation of sodium? 0 Theoretical Benefit 0 Theoretically, elevating the tonicity of the blood […]
Search Results for: status
IBCC – Neuroleptic Malignant Syndrome (NMS)
Neuroleptic malignant syndrome is rare, but this will be encountered in the ICU. Particularly with the rising utilization of antipsychotics for a variety of indications (e.g., emesis, agitation), we should be cognizant of this entity. Another relevent cause of NMS is abrupt withdrawal of Parkinson’s medications (e.g., due to NPO status). The IBCC chapter is […]
IBCC – Posterior Reversible Encephalopathy Syndrome (PRES)
Posterior Reversible Encephalopathy Syndrome (PRES) is a common cause of ICU admission for seizure or altered mental status. Although PRES is commonly associated with hypertension, PRES can occur in the absence of hypertension due to a variety of disorders that impair endothelial function causing vasogenic edema. Thus, PRES encompasses the entity of “hypertensive encephalopathy” – […]
Alcoholic Hepatitis
CONTENTS Clinical features Evaluation Alcoholic hepatitis vs. cirrhosis Management Podcast Questions & discussion Pitfalls clinical findings Common symptoms: Jaundice. Fever. Tender hepatomegaly. Nausea, vomiting, and anorexia. Patients may have superimposed features from underlying alcoholic cirrhosis (e.g., ascites). Severe disease may cause encephalopathy. epidemiology Alcoholic hepatitis occurs following chronic alcoholism (e.g., >>5 years), but it can […]
EMCrit Shadowboxing Case 3 – Chicken or Egg – Which Organ Failed First?
Shadow Boxing Respiratory Failure Case
EMCrit 180 – On Argumentation, Debate, Fallacies, and Twitter Misery
A slight diversion to discuss how to argue better
EMCrit 113 – Post-Cardiac Arrest Care in 2013 with Stephen Bernard – Part I
Dr. Stephen Bernard on the topic of post-arrest care
PulmCrit: Remdesivir 5-day vs. 10-day trial raises some red flags?
So, Gilead’s first RCT on remdesivir was just published, and it’s very interesting.1 Gilead’s, you say? Yep. The study was designed, monitored, analyzed, and written by Gilead: Before getting into the study, let’s take a moment and think about what Gilead’s first RCT could look like. Gilead knows more about remdesivir than anyone (they built […]
IBNCC – Catatonia
Catatonia is an important cause of altered mental status which is often overlooked among critically ill patients. Although traditionally associated with schizophrenia, catatonia can result from a variety of psychiatric, neurologic, and medical problems (similar to delirium). It is important to diagnose catatonia, because otherwise patients are likely to be incorrectly labeled as having delirium […]
answers to ABG/VBG questions
Here are the answers to todays discussion questions on ABG & VBG. A woman with history of heart failure, COPD, and recent international plane travel presents with dyspnea to the ED. ABG shows 7.52/29/65/23. What does this test reveal about her diagnosis? (2/6) — 𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊 (@PulmCrit) September 4, 2019 (1) Answer = 4. […]
EMCrit Wee – The Targeted Temperature Trial Changes Everything
Cold, but not all that cold may be the way
PulmCrit Wee – Who needs a second lumbar puncture to exclude HSV encephalitis?
the question Some patients with HSV encephalitis may initially have a negative CSF PCR for HSV, with a repeat being positive some days later. This has led to confusion regarding who, exactly, needs a repeat lumbar puncture? Montmollin E et al: HSV encephalitis with initial negative PCR: Prevalence, associated factors, and clinical impact. This is […]
Sympathomimetic intoxication
CONTENTS Overview Clinical presentation Evaluation Management Serotonergic medications to avoid Agitation Seizures Hyperthermia Hypertension Chest pain & acute coronary syndrome Arrhythmia Atrial fibrillation Monomorphic ventricular tachycardia QT prolongation & torsade de pointes Hepatic failure Respiratory complications Rhabdomyolysis Hyponatremia Podcast Questions & discussion Pitfalls common sympathomimetic intoxications: Cocaine. Methamphetamine: Illicit “crystal meth.” Medicinally prescribed methamphetamine, used […]
PulmCrit Table of Contents (TOC)
TOPICS airway & procedures cardiology endocrinology gastroenterology hematology/oncology infectious diseases nephrology neurology pulmonology rheumatology toxicology methodology & miscellaneous Airway pharmacology Medication sequence: rocketamine vs. keturonium Ketamine-tolerant patient Catastrophic complications, ROC vs. SUX Arterial lines: wrist versus the groin? Cricothyrotomy in asphyxial cardiac arrest Difficult airway communication via allergy list Drowned airway Large-bore suction strategies & […]
EMCrit 285 – More on Palliative Care Conversations in Resuscitation
A meandering conversation on end-of-life palliative care conversations
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