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 […]
Search Results for: TXA
Neurological complications of COVID
CONTENTS Limitations of this chapter Brief word on pathogenesis General clinical principles Encephalopathy Diffuse leukoencephalopathy with diffusion restriction Acute necrotizing encephalopathy (ANE) Mild encephalopathy with reversible splenial lesion (MERS) Acute disseminated encephalomyelitis (ADEM) & Acute hemorrhagic leukoencephalitis (AHLE) Myelitis Autoimmune encephalitis Posterior reversible encephalopathy syndrome (PRES) Stroke Acute ischemic stroke Intracranial hemorrhage & microbleeds Cerebral […]
Post-MI complications
CONTENTS Approach to the deteriorating post-MI patient Retroperitoneal hematoma Re-infarction Post-MI pericarditis Mechanical complications Mitral valve chordae tendinae rupture Ventricular septal defect (VSD) Ventricular free wall rupture LV pseudoaneurysm formation LV aneurysm & thrombus Dynamic LV outflow tract obstruction ➡️ Tachyarrhythmia Atrial fibrillation or atrial flutter Ventricular arrhythmias PVCs Nonsustained VT Sustained monomorphic VT Polymorphic […]
Clostridioides (prev: clostridium) difficile
CONTENTS Rapid Reference – Management of severe C. Difficile 🚀 Prevention and C. Diff-o-genic antibiotics Presentation & diagnosis Lab testing Colonoscopy Imaging Risk-stratification Treatment Non-standard therapies Podcast Questions & discussion Pitfalls Checklist for management of severe C. Difficile ✅ Sepsis resuscitation 📖 Imaging (Abdominal X-ray +/- CT scan) 📖 Consider serial abdominal X-ray to follow […]
Massive Transfusion Protocol (MTP)
CONTENTS Rapid Reference 🚀 Introduction to massive transfusion protocol (MTP) Procedural concerns Running the MTP 1) Blood products in 1:1:1 ratio 2) Fibrinogen supplementation? 3) Tranexamic acid? 4) Reversal of other coagulopathies 5) Calcium 6) Avoid acidosis 7) Avoid hypothermia 8) Hemodynamic management 9) Source control Post-MTP assessment & management Podcast Questions & discussion Pitfalls […]
Hyperthermia & heat stroke
CONTENTS Rapid Reference 🚀 Definition & diagnosis of hyperthermia Differential diagnosis Evaluation Treatment Sedation & Shivering tx Intubation if necessary Temperature control overview (1) Internal cooling: IV fluid (2) Surface cooling (3) Respiratory cooling Management of complications Podcast Questions & discussion Pitfalls what is hyperthermia? Fever is temperature elevation due to activity of the hypothalamus, […]
Bupropion intoxication
CONTENTS Overview Pharmacodynamics Pharmacokinetics Diagnostics & doses Clinical evolution Treatment Activated Charcoal Whole bowel irrigation Neurotoxicity management Cardiotoxicity management Podcast Questions & discussion Pitfalls Bupropion is increasingly used for several indications (depression, tobacco cessation, and ADHD). Unfortunately, it is also a uniquely dangerous and increasingly common source of intoxication (especially the extended-release formulations). For example, […]
Stress Inoculation Training by Mike Lauria
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Status Epilepticus
CONTENTS Getting started: (1) Initial approach to status 🚀 (2) After the dust has settled 🚀 Causes Diagnosis & definition Definition of status epilepticus Seizure mimics Differentiation from pseudoseizure Treatment overview Initial treatment Benzodiazepine Hypoglycemia, hyponatremia, and thiamine deficiency Conventional antiseizure medication Neurolytic intubation Subsequent management NORSE Neuromonitoring Waking & weaning Supportive medical management Approach […]
Purpura Fulminans
CONTENTS Rapid Reference 🚀 Basics of Purpura Fulminans Pathophysiology Common causes Clinical findings Diagnostic tests Diagnosis Treatment Antibiotics & source control Heparin & heparin resistance Protein C concentrates Blood product replacement Vasodilators Surgical debridement Vitamin K supplementation Podcast Questions & discussion Pitfalls basics Purpura fulminans is an extreme thrombotic subtype of disseminated intravascular coagulation, marked […]
Thyroid Storm
CONTENTS Rapid Reference 🚀 Approaching the diagnosis Diagnostic criteria Management Evaluation & treatment of any trigger Endocrine manipulations Cardiovascular stabilization Atrial fibrillation in thyroid storm Management of hyperthermia & agitation Refractory thyroid storm Podcast Questions & discussion Pitfalls evaluation 📖 Glucose, electrolytes including Ca/Mg/Phos, complete blood count. TSH, free T4, free T3. Liver function tests. […]
Posterior Reversible Encephalopathy Syndrome (PRES)
CONTENTS Basics Pathogenesis Causes Clinical presentation PRES-RCVS (Reversible Cerebral Vasoconstriction Syndrome) overlap Imaging Lumbar puncture EEG & seizure semiology Diagnosis Differential diagnosis Treatment Prognosis Podcast Questions & discussion Pitfalls PRES refers to reversible, vasogenic edema which occurs predominantly in the posterior brain. PRES is less commonly known as “reversible posterior leukoencephalopathy syndrome” (RPLS). However, both […]
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 […]
Autoimmune Encephalitis
CONTENTS Definitions & classifications General clinical features Diagnostic evaluation CSF evaluation MRI EEG Evaluation for underlying malignancy Anatomic classification Limbic encephalitis Cortical-subcortical encephalitis Basal ganglia involvement, including striatal encephalitis Diencephalic encephalitis Brainstem encephalitis Cerebellitis Meningoencephalitis Encephalomyelitis Classification by antibody Antibodies against intracellular proteins Antibodies against cell surface proteins Management of autoimmune encephalitis Specific disorders Anti-NMDA […]
Evidence for the Protocols
Evidence for Non-Invasive Protocol The paper that allowed us to start non-invasive protocols=gamechanger. [1. Jones AE, Shapiro NI, et al.; Emergency Medicine Shock Research Network (EMShockNet) Investigators. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010 Feb;303(8):739?46.] Is septic shock without lactate elevation as sick […]
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