CONTENTS Rapid Reference 🚀 Causes of tamponade Symptoms Physical exam Pulsus paradoxus Kussmaul’s sign EKG Radiology Echocardiography Diagnosis: Overall approach Low pressure tamponade Management Initial stabilization measures Ultrasound-guided pericardial drainage Interventional radiology or surgical drainage Tamponade patient in cardiac arrest Finer points: Limitations of this chapter Physiology Podcast Questions & discussion Pitfalls Key tests to […]
Search Results for: ultrasound
A Case of Shadows
In medicine we frequently propagate half-truths and unsubstantiated certainties. Thus, truth is a relative experience, dependent primarily on how we choose to define it rather than any concrete state of reality. Increasingly we have favored a technological definition of truth over that of the clinical perspective. As such we are driven to act in disease […]
EMCrit Wee – RACC-Lit for August 2022
So much literature goodness for the scorching summer heat…
Episode 6 – ACCP Antithrombotics and VTE Guidelines
Antithrombotic Therapy and Prevention of Thrombosis, 9th ed Guidelines from the American College of Chest Physicians
PulmCrit Wee: MDCalc for the perfect tape-measure intubation
Imagine you went to buy an expensive piece of clothing. Rather than measuring your size, the store owner simply said “well, on average most folks require a medium, so let’s try that on, we can always re-size it later.” You would be irritated that they were wasting your time. When you go clothes shopping, you […]
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.
Community acquired biliary sepsis (ascending cholangitis & calculus cholecystitis)
CONTENTS Rapid Reference 🚀 Introduction Clinical presentation & differential diagnosis Diagnostic tests Labs Ultrasonography CT scan HIDA scan Diagnostic criteria Treatment Antibiotics Interventional tx for ascending cholangitis Interventional tx for cholecystitis Interventional tx for combined cholecystitis & cholangitis Podcast Questions & discussion Pitfalls community-acquired biliary sepsis checklist ✅ investigations Electrolytes, CBC with differential, coags. Liver […]
EMCrit Guest Post – The good, the bad, and the ugly of the Joint Statement on REBOA by Zaffer Qasim
@emeddoc on the current state of REBOA and that bad, bad joint agreement:
PulmCrit Blogitorial – New IDSA/SCCM guidelines on fever evaluation in ICU
More guidelines! Today we’ll walk through some interesting bits of the new IDSA/SCCM guideline on evaluation of new fever in the adult ICU patient (available free here). how should temperature be evaluated? This is frankly a mess. Bladder catheter or esophageal probe are best, but usually not used. Rectal temperature is 2nd best, but unwieldy […]
Submassive & Massive PE
CONTENTS Most useful material: Crashing patient: Massive PE resuscitation guide 🚀 General approach to (sub)massive PE: (#1) Investigation package (#2) Risk stratification (#3) Thrombolytic contraindications (#4) Treatment approach Resuscitation of massive PE Avoid procedures if possible Fluid management Inotropes & vasopressors Inhaled pulmonary vasodilator(s) Hematologic management: Anticoagulation (heparin) Thrombolysis Regimens: Full dose Half dose Quarter […]
EMCrit 248 – How to Teach Surgical Airways–you knows, Crics: The One-Hour Cricothyrotomy Course
Lessons learned from teaching hundreds of people to cric
EMCrit 374 – ShadowBoxing – An AMAXimally Sick Patient
An AMAX4 shadowboxing case
PulmCrit – Understanding happy hypoxemia physiology: how COVID taught me to treat pneumococcus
Happy hypoxemia is severe hypoxemia (poorly responsive to supplemental oxygen) without dyspnea. This isn’t anything especially new – we have occasionally seen this since time immemorial. However, COVID is causing us to re-think how to manage this physiology. understanding the paradox of happy hypoxemia The key to understanding this is thinking about oxygenation and CO2 […]
EMCrit 42 – A phD in EKG with Steve Smith
Electrocardiograms can be subtle; but you can’t miss them or patients die. Today, I interview, Dr. Stephen Smith of the incredible blog: Dr. Smith’s EKG Blog.
EMCrit Wee – Ross Prager on 10 Heuristics for the New ICU Attending
10 heuristics for the new Crit Care doc from Ross Prager
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