Introduction 0 It’s common for critically ill patients to be screened for MI using troponin. Troponin levels are often positive. One thing leads to another, and before you know it the frail 99-year-old lady you admitted for a COPD exacerbation has an intracranial hemorrhage from the heparin drip she was put on because her troponin […]
“A Timely Reexamination of the Case of the Thirteen Watches”
-Doing the same thing over and over again and expecting different results Albert Einstein on Insanity- For a near decade now our mad dash to the cath lab has been based off flawed data and an illogical certainty that every moment of delay is detrimental to our patients. As such we were completely flabbergasted […]
EMCrit Wee – Sean Townsend of the SSC and the ProCESS Trial
I talk with a member of the surviving sepsis campaign steering committee re: ProCESS
PulmCrit – Four DKA Pearls
Introduction I have a confession to make: I love treating DKA. It’s satisfying to take a patient from severe acidosis, electrolytic disarray, and hypovolemia to normal physiology during an ICU shift. Although it’s usually straightforward, there are some pitfalls and a few tricks that may help your patients improve faster.0 Pearl #1: Avoid normal saline […]
EMCrit 123 – Selective Aortic Arch Perfusion (SAAP) with Jim Manning
What if you had a REBOA catheter through which you could give blood and drugs?
Fluid selection using pH-guided resuscitation
0 PART 1: Fluid selection for resuscitation of hypovolemic, hyperkalemic renal failure 0 Introduction with a case 0 An elderly man on an ACE inhibitor and NSAIDs presents to the emergency department after a few days of severe norovirus gastroenteritis with a creatinine of 5 mg/dL, a bicarbonate of 15 mEq/L, and a potassium of […]
My Reflections on #SMACCGold
well, actually not mine at all.
In-Situ Sim
MobileSim Site
EMCrit Wee – A Cric Case with Rob Bryant
Rob Bryant presents a case
EMCrit 122 – Cardiac Arrest after the Toxicology of Smoke Inhalation with Lewis Nelson
What is the proper care for a patient in cardiac arrest or shock after smoke inhalation if they don’t have severe burns?
Submassive PE: Are we treating it backwards?
Introduction 0 Submassive PE can be challenging. Most patients do fine with heparin, but occasional patients suddenly arrest and others are left with longstanding pulmonary hypertension.1 Thrombolytics generally cause dramatic improvement, but may cause hemorrhage as well. Recent studies may seem to point in opposite directions. 0 Background: Heparin vs. Alteplase 0 Treatment centers around […]
“The Adventure of the Greek Interpreter Revisited”
If our affair with thrombolytics had not started off with the success it did, we may not still be trying to nostalgically relive our yesteryears of throbolytic glory. Whether it was streptokinase, alteplase or tenectoplase (TNK), thrombolytics have consistently demonstrated a mortality benefit when used in patients experiencing an ST-elevation infarction (1). If it […]
150 Lives in 150 Days
Sepsis Collaboratives work in Canada too
Which Airway Mannequin for Resuscitationists?
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US Emergency Physicians Must Read this Piece
Gross Negligence?
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