CONTENTS Introduction Physiology Epidemiology Clinical findings Echocardiographic diagnosis Management Esmolol Podcast Questions & discussion Pitfalls Supplemental Media Dynamic left ventricular outflow tract obstruction (LVOTO) creates a confusing hemodynamic picture. If unrecognized, LVOTO will fail to respond to standard hemodynamic therapies. Indeed, LVOTO will often respond to various interventions in the opposite fashion than might be […]
Search Results for: cardiac arrest
EMCrit RACC Lit Review – September 2023
All the amazing RACC literature for September 2023
EMCrit Wee – A Case to Threaten Current ECMO Evidence from Sam Ghali
Should we be extending ACLS in patients we really want to save?
Takotsubo syndrome
CONTENTS Epidemiology Symptoms Diagnostic studies ECG Phase I: STE Phase II: TWI Reverse Takotsubo Prominent T-waves Echocardiography Cardiac MRI Labs Diagnostic approach Treatment [1] Treat underlying problem [2] Anticoagulation [3] Arrhythmia management [4] Hemodynamic management [4a] Hemodynamically stable patient [4b] Hemodynamically unstable with LVOTO [4c] Hemodynamically unstable without LVOTO Prognosis Pathophysiology Podcast Questions & discussion […]
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 352 – Airway Update 2023
So today we have our June-u-airway update… A bunch of papers and thoughts on how you should be intubating in 2023. DSI for everyone, induction agent choice, apox and much more!
PulmCrit- All 2nd line conventional anti-epileptics are equally good… or equally bad?
The management of generalized convulsive status epilepticus remains in perpetual status controversius. There is consensus that the front-line agent should be a benzodiazepine, but little agreement beyond that. The much-awaited ESETT trial is a multi-center RCT comparing three anti-epileptic agents for ongoing status epilepticus (levetiracetam, fosphenytoin, and valproate). This trial will be the highest-quality evidence […]
EMCrit 84 – The Post-Intubation Package
There is a ton of stuff to do post-intubation besides confirming the tube and giving the team high-fives. What we do in the ED has ramifications on the patient’s course in the hospital.
PulmCrit – I’m upset about the RELAX trial
Some studies have reported a gradual upwards trend in the PEEP being used for intubated patients without ARDS (e.g., from 5 cm to 7 cm). Is this good or bad? That is the question which the RELAX trial embarked upon answering. It’s a complex question which probably doesn’t have a binary answer… but never mind – let’s get to the study.
Waveform capnography in the intubated patient
CONTENTS Rapid Reference 🚀 Introduction: An emerging standard of care Physiology etCO2, PaCO2, and dead space etCO2 and cardiac output Clinical background Evidence: accuracy of etCO2 in predicting PaCO2 What is the PaCO2 target for an intubated patient? Interpretation of etCO2 waveform morphology Clinical utility Confirming endotracheal tube placement Guidance of cardiac arrest management Guidance […]
Sodium Channel Blocker Toxicity (including tricyclic antidepressants)
CONTENTS Overview – sodium channel blockers & tricyclic antidepressants Pathophysiology and terminology Agents that inhibit cardiac sodium channels Diagnosis EKG findings of sodium channel blockade Clinical manifestations Management – three antidotes #1) Bicarbonate #2) Lidocaine #3) Lipid emulsion Management – clinical approach Intubation if necessary Hypotension Ventricular tachycardia Seizure Podcast Questions & discussion Pitfalls Tricyclic […]
PulmCrit- Brain death, mimics, and flow scans
As with many uncommon situations that are unique to critical illness, we cannot always rely on specialist consultation. Critical care practitioners must develop a firm grasp of this diagnosis. This post will explore some diagnostic conundrums in brain death diagnosis. The radionuclide flow scan is emphasized because it is the most commonly used tool to sort out difficult cases.
EMCrit 371 – Iodinated Contrast Issues: Part 2 – Contrast Reactions
Continuing on our contrast issues theme…
EMCrit 339 – Decisions, Decisions, Decisions with Andrew Petrosoniak
Making good decisions is the heart of Emergency Medicine and Critical Care…
EMCrit 374 – ShadowBoxing – An AMAXimally Sick Patient
An AMAX4 shadowboxing case
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