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emDOCs Podcast – Episode 85: Tricky Cases Part 1

EMDocs

Removed from cooling at 102 and admitted to ICU. 2016 study published in American Journal of Emergency Medicine , “ Urinary obstruction is an important complicating factor in patients with septic shock due to urinary infection ” by Reyner et al. Reference: Reyner K, Heffner AC, Karvetski CH. 2016 Apr;34(4):694-6.

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

Chinawa JM, Ubesie AC, Chukwu BF, Ikefuna AN, Emodi IJ. 2016 Dec;91(12):1185-1190. Epub 2016 Oct 3. -smoke, high ozone levels, smog) Asthma/reactive airway disease (RAD) Diagnostic criteria 7,8 Respiratory symptoms +/- fever (at least 38.0 C or 100.4 mg/kg, max 4 mg per dose q20-30min) or hydromorphone (0.01-0.02 mg/kg, max 0.4

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EM@3AM: Basilar Artery Occlusion

EMDocs

The NIHSS cutoff that predicts outcomes is 4 points higher in AC compared with PC infarctions. All patients who receive thrombolytics for ischemic stroke should be admitted to a neurosurgical, neurologic, or medical ICU for management and monitoring, as this is shown to decrease mortality and length of stay. Epub 2016 Jul 15.

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ABG Versus VBG in the Emergency Department

EMDocs

In this situation, an ABG should be obtained periodically for correlation, though this is more relevant for the intensive care unit (ICU) setting than in routine ED care (5, 9). Epub 2016 Jun 9. 11) Webb RK, Ralston AC, Runciman WB. 2016 Feb;33(2):152-4. J Intensive Care Med. 2018 Mar;33(3):176-181. PMID: 11685301. (10)

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Inotropes and Vasopressors: Doses, indications, contraindications and effects

ECG & Echo Learning

Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). Gordon AC, Mason AJ, Thirunavukkarasu N, et al. JAMA 2016; 316:509. Several endogenous and synthetic agents exist and are frequently combined to achieve the desired hemodynamic outcome.

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Congestive Heart Failure and Sepsis: A Closer Look at Fluid Management

REBEL EM

Article: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM. Studies without IRB approval Studies older than 2016 Intervention: Administration of <30 mL/kg IV crystalloid fluids within three hours of sepsis identification. Secondary Outcomes: Delayed hypotension, increased ICU stay, and other relevant outcomes.

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EM@3AM: Cardiac Transplant Complications

EMDocs

Answer : Cardiac Transplant Complications Epidemiology: There were over 3,000 heart transplants in North America in 2016. 15 Patients with a heart transplant can have ACS though they are unlikely to present with classic, crushing chest pain due to transplant-induced changes in cardiac innervation.

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