In this podcast, I explain why I don’t think needle compression is such a clever idea. Main points are: most people can’t find anterior target, most angiocaths won’t reach, and if used diagnostically you may not be in the pleura leading to an unidentified pneumo or hemothorax. Also, when used diagnostically, if the chest was negative you just caused a pneumothorax.
Search Results for: asthma
Septic Shock
CONTENTS Rapid Reference 🚀 Definitions of septic shock Diagnosis & evaluation Clinical Presentations Biomarkers: NLR Procalcitonin & CRP ➡️ Evaluation for the source Sepsis mimics Treatment Vasopressors Source control Fluid Steroid DVT prophylaxis with heparin REFRACTORY SHOCK Methylene blue Resuscitative endpoints MAP Heart rate Urine output Fluid balance Lactate Skin perfusion Interventions of no real […]
EMCrit Wee – Follow-Up to the Ghali Grills Episode on APRV
More on yesterday’s APRV episode
Approach to pulmonary infection
CONTENTS tests & approaches Approach to pulmonary infections Infectious disease history 12 organisms to consider Selected radiological associations Noninvasive infectious evaluation Bronchoscopy: tests to consider Antibiotic selection Animal exposures Selected diagnostic tests: Beta-D-glucan Galactomannan Atypical lymphocytosis specific immunocompromising disorders HIV Kaposi sarcoma (KS) Pulmonary hypertension due to HIV ➡️ IRIS (immune reconstitution inflammatory syndrome) Transplantation […]
EMCrit 266 – High Sensitivity Troponins with Louise Cullen
High Sensitivity Troponins are coming
PulmCrit Instagram Links
Welcome to the PulmCrit Instagram page. This has recent posts with links for further information. –Cheers, josh HYPERION trial on therapeutic hypothermia for patients with non-shockable cardiac arrest: Link to PulmCrit blog. CITRIS-ALI: Fresh multi-center RCT of vitamin C in sepsis-induced ARDS: Link to PulmCrit blog The crashing asthmatic with Leo Stemp: Link to fresh […]
COVID 19 Complete Chapter
CONTENTS Basic biology Infection control Transmission Personal protective equipment (PPE) Diagnosis Signs & symptoms Labs Imaging CXR & CT scan Lung ultrasonography General approach to imaging Bronchoscopy Diagnostic approach for admitted patients Treatment: General protocols ED patients getting admitted to the hospital Inpatient management of hypoxemic, non-intubated patients Intubated patients Treatment: Specific anti-viral & immunosuppressive […]
COVID Airway Management Thoughts
additional COVID airway management thoughts
EMCrit 304 – Cerebral Venous Thrombosis (CVT)
Atypical headache=SAH w/u right? Except sometimes it is CVT. This is a critical diagnosis to make and to treat properly. Today I interview @caseyalbin on EMCrit 304 – cerebral venous thrombosis
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- Top ten problems with the new sepsis definition
A satisfactory clinical definition of sepsis has been eluding us since the ancient Greeks first coined the term. Current definitions of sepsis attempt to achieve two goals: to provide a rapid screening test to detect sepsis and to render a definitive diagnosis of sepsis. However, it remains unclear whether any definition can achieve this.
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 & […]
The Third Annotation of a Case of Identity
So often in modern medicine we mistake science for truth. In doing so we have become enamored with the p-value and view it as the major determinant of relevance in scientific inquiry. An almost arbitrary selected value of 0.05 is independently responsible for defining what is considered beneficial, and what will be discarded as medical […]
A Case of Identity Part Two
Our standards for acceptable benefit of antiplatelet agents in the management of ACS have become deplorably low. When ISIS-2 was first published we defined success only by aspirin’s ability to affect mortality. The number commonly cited, 2.4%, only describes aspirin’s absolute benefit to decrease death (1). In the one trial that examined its properties to […]
Approach to thoracic imaging in acute illness (radiograph, CT scan)
CONTENTS Preamble: A slightly different approach Frontal chest radiograph algorithm CT algorithm (1) Lines & tubes (2) Right heart & pulmonary embolism Contrast reflux into the IVC Pericardial effusion Right atrial dilation Right ventricular dilation Right ventricular wall thickness Pulmonary artery dilation Evaluation for PE (3) Left heart Left atrial dilation Left ventricular dilation Left […]
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