CONTENTS Approach to pulmonary dysfunction in a patient with cancer Specific disorders Parenchymal lung metastases Leukostasis Pulmonary leukemic infiltrates Airway metastases Malignant pleural effusion (MPE) ➡️ Lymphangitic carcinomatosis Pulmonary tumor emboli Pulmonary tumor thrombotic microangiopathy (PTTM) Pulmonary tumor macroemboli ➡️ Benign metastasizing leiomyoma (BML) Iatrogenic: Radiation pneumonitis Checkpoint inhibitor pneumonitis Other topics: Pulmonary complications from […]
Search Results for: ecmo
PulmCrit- Inhaled NO for submassive PE: iNOPE or iYEP?
The use of an inhaled pulmonary vasodilator is a logical strategy for stabilization of PE patients (especially nitric oxide, which may be depleted in this situation). Previously inhaled nitric oxide has only been supported by case series.
“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 […]
EM Nerd-A Case of Shadows Continues
The use of point of care ultrasound (POCUS) in the Emergency Department is a Bayesian playground for those willing to indulge. Take for example the performance of POCUS in the diagnosis of pulmonary embolism (PE). The poor sensitivity of bedside echocardiography to identify all-comers with pulmonary embolism is well documented. Most series cite a sensitivity […]
Flipping the Podcast: Approach to shocky patient in AF w/ RVR
Flipping the podcast? I’m going on Tyler Christifulli’s FOAMFrat podcast soon to talk about the approach to the shocky patient in atrial fibrillation with rapid ventricular rate (AF with RVR). Tough topic. I’ve been trying to iron out some general algorithms for this, but they aren’t perfect. So I thought it might be fun to […]
EEMCrit Resident Competition 2018
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ODR 005 – NonViolent Communication
One of the most important books I have read…
PulmCrit- Why we fail at hemodynamics: The flaw of averages & the swan’s curse
With a resurgence of the Swan, a resident recently asked me: why don’t we use the Swan to guide sepsis resuscitation? Answering this question forced me to recognize that many problems with the Swan continue to haunt us today when using our new darling, bedside echocardiography.
Approach to shock
CONTENTS Introduction Diagnosis Causes of shock Evaluating the cause of shock Stabilization Refractory shock management ➡️ Podcast Questions & discussion Pitfalls Shock is a state of systemic hypoperfusion, with inadequate blood supply to the tissues. Unfortunately, this may occur in different ways. The most simple physiology of shock is cardiogenic shock, with low cardiac output […]
Post-MI complications
CONTENTS Approach to the deteriorating post-MI patient Re-infarction Post-MI pericarditis Bleeding & clotting: Retroperitoneal hematoma Left ventricular thrombus Mechanical complications Mitral valve chordae tendinae rupture Ventricular septal defect (VSD) Ventricular free wall rupture Tachyarrhythmia Atrial fibrillation or atrial flutter Ventricular arrhythmias PVCs Nonsustained VT Sustained monomorphic VT Polymorphic VT AIVR (accelerated idioventricular rhythm) Sinus tachycardia […]
A Case of Identity
On August 17th 2013 The Lancet published what appears to be Eli Lilly’s face saving article on its derailed quest to replace its predecessor, clopidogrel (1).In its attempt to emulate Bristol Meyer with its triple C (CURE, CREDO, CLARITY) trials, pull the wool over the healthcare industry’s global eyes and become the second leading sold drug […]
EMCrit 146 – Who Needs an Acute PCI with Steve Smith (Part I)
Finally in one place, all of the STEMI equivalents with Steve Smith
PulmCrit- Solving the OPTALYSE PE riddle: We’re dosing tPA wrong
Occasionally in science we encounter a truly bizarre result. Our natural inclination is to ignore the bizarre result. It’s jarring. It creates cognitive dissonance, challenging our understanding of the world. However, struggling to understand the bizarre result can reset our perspective. It’s often the bizarre, unexpected result that changes everything.
EMCrit Shadowboxing Case 5 – NeuroEMCrit Case
A NeuroEMCrit Shadowboxing Case
PulmCrit – Early basal insulin in DKA
The timing of basal insulin administration in DKA has been controversial for years. I posted the following poll on twitter recently to get a sense of current opinion on this: So, it seems that the majority of people are using traditional management (wait for the anion gap to close, give basal insulin, then shut off […]
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