CONTENTS Rapid Reference 🚀 Primer Basic physiology of APL Why APL is important in critical care Diagnosis Epidemiology Clinical presentation Diagnostic studies Treatment Early initiation of ATRA Coagulopathy of APL Differentiation syndrome Sepsis Complications from arsenic trioxide Pseudotumor cerebri Podcast Questions & discussion Pitfalls Acute Promyelocytic Leukemia (APL) management ✅ basic workup & monitoring 📖 […]
Search Results for: TXA
PulmCrit- Sepsis special edition & CBC to diagnose septic shock
The Journal of Thoracic Diseases is about to release a special edition on sepsis, edited by Paul Marik (open access). It’s deliciously rebellious – just look at the table of contents 👇 My article on using the complete blood count to diagnose sepsis is already available, so I’ll summarize it here (yes, I know, you […]
Community acquired biliary sepsis (ascending cholangitis & calculus cholecystitis)
CONTENTS Rapid Reference 🚀 Introduction Clinical presentation & differential diagnosis Diagnostic tests Labs Ultrasonography CT scan HIDA scan Diagnostic criteria Treatment Antibiotics Interventional tx for ascending cholangitis Interventional tx for cholecystitis Interventional tx for combined cholecystitis & cholangitis Podcast Questions & discussion Pitfalls community-acquired biliary sepsis checklist ✅ investigations Electrolytes, CBC with differential, coags. Liver […]
PulmCrit Wee – Therapeutic anticoagulation for COVID ICU patients: Is the heparin vial half empty, or half full?
A fresh preprint reveals the results of combining three trials to evaluate therapeutic anticoagulation among severe COVID patients (defined as patients requiring high flow nasal cannula, noninvasive ventilation, intubation, vasopressors, or inotropes). Patients were randomized to therapeutic anticoagulation versus thromboprophylaxis per usual care guidelines. REMAP-CAP also simultaneously randomized some patients to receive aspirin as well. […]
The fallacy of time-to-intervention studies
0 Time and tide wait for no intervention – Geoffrey Chaucer 0 We are barraged by time-to-intervention studies (door-to-balloon time, time-to-antibiotics, door-to-needle, etc.). However, it must be kept in mind that these studies are purely correlational in design. Such studies cannot […]
Acute Disseminated Intravascular Coagulation (DIC)
CONTENTS Rapid Reference 🚀 Pathophysiology Symptoms Lab studies Causes Differential diagnosis Diagnostic criteria Sepsis-Induced Coagulopathy (SIC) Management Podcast Questions & discussion Pitfalls sepsis induced coagulopathy (SIC): ISTH DIC score: general concept of DIC Normally, clots form locally at sites of vascular damage. These clots are subsequently degraded after tissue damage is repaired. The processes of […]
EMCrit RACC Lit Review – May 2023
all the lit goodness…
Coagulation tests (conventional & viscoelastic)
CONTENTS Rapid Reference 🚀 Cell-based coagulation model Traditional tests of enzymatic coagulation INR prolongation with normal PTT PTT prolongation with normal INR Prolongation of both INR & PTT Thrombin Time & fibrinogen “level” (Clauss assay) Thromboelastography (TEG) Strengths and weaknesses of TEG TEG interpretation Using TEG to guide blood product transfusion Platelet dysfunction in critical […]
Catastrophic Antiphospholipid Syndrome (CAPS)
CONTENTS Rapid Reference – When to consider CAPS? 🚀 Pathophysiology Epidemiology & precipitating factors Clinical presentation Lab tests Testing for antiphospholipid antibody syndrome Laboratory abnormalities seen in CAPS Laboratory panel to investigate for possible CAPS Tissue diagnosis Differential diagnosis Diagnostic criteria Treatment Podcast Questions & discussion Pitfalls Diagnosing CAPS is challenging. A thumbnail of clues […]
EMCrit 368 – The Acute Critical Care Medication Reconciliation with Josh Farkas
The acute crit care med rec
A Truncated Summation of the Adventure of the Cardboard Box
One gets the sense when reading the literature on endovascular therapy for acute ischemic stroke that they are on a small seafaring vessel attempting to map the shoreline through a dense fog. There are moments when the fog lifts and you catch a glimpse of the topographic details of the shore, and then the […]
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 […]
Pleural effusion
CONTENTS approach to pleural effusion of unclear etiology Initial trifecta: History CXR, POCUS, & review of prior radiology Blood tests More advanced testing: CT scan Thoracentesis differential diagnosis All causes of pleural effusion Transudates Exudates pleural radiology POCUS Chest radiograph Subpulmonic effusion Pseudotumor Specific radiologic findings: Chronic pleural effusion Rapidly growing effusion Pleural plus pericardial […]
Decompensated Hypothyroidism (“Myxedema Coma”)
CONTENTS Rapid Reference 🚀 Diagnosis Epidemiology (including triggers) Recognition of the clinical syndrome Catalog of potential findings Investigations Definition & differential Treatment Treatment of cause Supportive care Hormonal manipulations Stress dose steroid IV levothyroxine (T4) Liothyronine (T3) Followup Podcast Questions & discussion Pitfalls basic workup should include: Endocrine evaluation: TSH & free T4. Random serum […]
The Adventure of the Resident Patient
In a properly automated and educated world, then, machines may prove to be the true humanizing influence. It may be that machines will do the work that makes life possible and that human beings will do all the other things that make life pleasant and worthwhile. -ISAAC ASIMOV The term Cyborg, short for […]
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