EMCrit Project

Origins of the Dope Mnemonic

All the way back in episode 16, I asked if anyone knew the origins of the DOPE mnemonic for post-intubation desaturation. Nobody had an answer until now. Here is an email from Ahad…

EMCrit 39 – Hyponatremia

Hmm… he’s tasty, but he just needs a little salt! In this podcast, I discuss the management of hyponatremia in the ED.

EMCrit 38 – The ED Critical Care Dirty Dozen for 2010

My favorite ED things for 2010…the EMCrit dirty dozen.

When an ED starts providing advanced care for severe sepsis, lactate testing is an absolute requirement. Lactate use brings up a lot of questions, especially if it is not commonly ordered in your department. In this podcast, I discuss all of the lactate questions that have come up in the course of the NYC Sepsis Collaborative.

EMCrit 36 – Traumatic Arrest

Management of traumatic arrest. Many things to do in these patients, but two things you definitely should not be doing are closed-chest CPR or giving ACLS medications. We discuss who gets a thoracotomy, what to do if a thoracotomy is not indicated, and when to stop.

EMCrit 35 – Extubation in the ED

In this podcast, I discuss extubating patients in the ED. Specifically, I deal with patients who have only been intubated for a few hours in distinction to extubation of the patient who has been lingering in your ED for 2-3 days. The best patients for this short-term extubation are those intox folks with a low GCS and signs of trauma, overdoses, or endoscopy cases.

EMCrit 34 – 2010 ACLS Guidelines

The brand new ACLS & BCLS guidelines were published last week. Not huge changes, but some good stuff! The free full text is available at the Circulation website. It takes hours to make your way through all of it. I boiled it down to just the facts and posted a summary on the EMCrit site. In this EMCrit Podcast I discuss some of the highlights that I think are particularly important.

EMCrit 33 – Diagnosis of Posterior Stroke

What if I told you that I think that patient you just sent home with vertigo may have been a missed cerebellar stroke? Would you be dialing risk management or could you tell me all of the reasons why I’m wrong? Isolated vertigo without other neurological findings can’t be a stroke, right? That is true, if you are doing the right exam, but if you are just doing your standard ED neuro screening exam then you might be missing serious pathology. In this episode of the EMCrit podcast, I discuss how to perform the tests that will differentiate a peripheral cause of continuous vertigo from a cerebellar stroke.

Additional Resources for ACEP 2010 Lectures

If you have just attended one of my two lectures at ACEP 2010, here are the promised additional resources:

EMCrit 32 – Treatment of Severe Hyperkalemia

Hey folks. As I get ready for ACEP, I just wanted to get a quick podcast put up. One of the listeners requested an episode on the treatment of hyperkalemia in the ED.

EMCrit 31 – Intra-Arrest Management

This week we talk about managing the intra-arrest period of cardiac arrest. My paradigm has changed dramatically over the past few years. In the past, I viewed the arrest as a period to teach my residents how to place a subclavian central line, how to intubate when the patient is moving, and how to cram as many drugs as possible into a patient in a short period of time. Looking at how I manage an arrest today, so much has changed.

Product Review: Optyse Ophthalmoscope

After the meningitis episode, one of the listeners, David Thomas, recommended I check out a new opthalmoscope from a UK company.

ACEP Preview – Hemostasis: Stopping the bleeding in a crashing trauma patient

I’m lecturing at ACEP in Las Vegas this year. This is one of two lectures I’m giving there. If you are going to the conference and plan on coming to my lecture, don’t listen to this lecture; I’d rather you here the real one in person.

EMCrit 30 – Hemorrhagic Shock Resuscitation

This week we discuss the resuscitation of the hemorrhagic shock patient with Dr. Richard Dutton, MD.

EMCrit 29 – Procedural Sedation, Part II

It seems the government and other specialties are trying hard to make sedation as difficult as possible in the ED. We must persevere to provide the best procedural sedation to allow maximal comfort and safety for our patients. This continues the discussion started in Part I.

All the Rest