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AHA/NCS Statement on Critical Care Management of Post ROSC Patients

EMDocs

Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association (AHA) and Neurocritical Care Society (NCS) released their 2023 Scientific Statement on the critical care management of post ROSC patients. Neurocrit Care. 2023 Dec 1. Treat seizures if present.

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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. Guideline-based and restricted fluid resuscitation strategy in sepsis patients with heart failure: A systematic review and meta-analysis [published online ahead of print, 2023 Aug 9]. References: Vaeli Zadeh A, Wong A, Crawford AC, Collado E, Larned JM.

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Simulation Brain Wash

FOAMfrat

This kid had sticks go through his cheek from running with a lollipop, hit by a car, almost kidnapped, attacked by a dog, and almost burnt his house down by throwing a 9-volt battery in the trash. References Kimbrell J, Kreinbrook J, Poke D, Kalosza B, Geldner J, Shekhar AC, Miele A, Bouthillet T, Vega J. Prehosp Emerg Care.

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emDOCs Revamp – Acute Chest Syndrome

EMDocs

Abdomen : ND, NT, no guarding or rebound MSK : Tenderness to palpation over L ribs 7-9 Derm : No rashes Imaging: Image 1: Case courtesy of Miriam Leiderer, Radiopaedia.org, rID: 81468 Chest radiograph (CXR) shows new left lower lobe opacity What’s most likely diagnosis? 2022 Jul 5;328(1):57-68. C or 100.4 mg/kg, max 0.4

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Inotropes and Vasopressors: Doses, indications, contraindications and effects

ECG & Echo Learning

Most agents exhibit both vasopressor and inotropic effects (Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). Careful electrocardiographic and hemodynamic monitoring with ECG , central vein catheter and intra-arterial catheter (A-line) is warranted.

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ABG Versus VBG in the Emergency Department

EMDocs

Introduction Arterial blood gas (ABG) or venous blood gas (VBG) testing is used to assess the pH and systemic carbon dioxide tension in patients, and, therefore, provide a more complete picture of their acid-base status than an isolated basic metabolic panel (BMP) (1). However, ABGs have many drawbacks compared to VBGs.

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EM@3AM: Crush Injury

EMDocs

1-3 Common causes: Natural disasters such as tornadoes or earthquakes 4,5 Structure or building collapses from home fires or bombings. Critical Care. 2016;20(1):135. Goodman AD, Got CJ, Weiss AC. Stahl K, Rastelli E, Schoser B. 2012;27 Suppl 1:i1-67. Critical Care. Genthon A, Wilcox SR.

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