EMOttawa

JANUARY 25, 2024

Mechanical ventilation has a lot of nuance associated with it, but a lot of reference guides focus on care in the ICU. There is certainly a need for more practical application for the ED doc or initial setup of patients on the vent.

ICU 143

ICU ED OR Critical Care 143

The Skeptics' Guide to EM

OCTOBER 3, 2021

Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Consultant in the Department of Critical Care Medicine at Mayo Clinic Arizona. Many critically ill patients receive intravenous crystalloids for volume expansion as part of their resuscitation. Reference: Zampieri et al.

OR 130

OR Critical Care ICU Plasma 130

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center.

CPR 130

CPR ICU Critical Care Defibrillator 130

The Skeptics' Guide to EM

JUNE 22, 2024

Anireddy Reddy is a pediatric intensive care attending physician in the Department of Anesthesiology and Critical Care Medicine at Children’s Hospital of Philadelphia. Dr. Anireddy Reddy Case: A 3-year-old girl presents to the emergency department (ED) with fever and respiratory distress.

ICU 141

ICU Critical Care ALS Emergency Department 141

Broome Docs

JANUARY 27, 2025

European Journal of Internal Medicine , [link] You can listen to my 27-minute rant on Youtube here: [link] This multinational trial looked at a three-pronged diagnostic protocol in the ED for adults with suspected acute aortic syndromes. The protocol used the ADD score, a POCUS echo protocol and D-dimer to try and exclude AAS in the ED.

ED 101

ED OR ACS Critical Care 101

The Skeptics' Guide to EM

JULY 16, 2022

Case: A 59-year-old woman presents to the emergency department (ED) with fever, tachycardia, and hypotension. She is admitted to the intensive care unit (ICU) for septic shock. The ICU team is considering using Vitamin C therapy for this patient. The ICU team is considering using Vitamin C therapy for this patient.

ICU 100

ICU ALS Critical Care Emergency Department 100

Emergency Medicine Ireland

FEBRUARY 1, 2021

Welcome back to the tasty morsels of critical care podcast. A meandering monologue through critical care exam preparation. Not content with producing deafness and killing kidneys they’ve also demanded awkward dosing schedules, Read More » Welcome back to the tasty morsels of critical care podcast.

Critical Care 40

Critical Care ICU ED 40

Emergency Medicine Ireland

FEBRUARY 21, 2022

Welcome back to the tasty morsels of critical care podcast. I don’t think I’ve ever looked after a true myasthenic crisis in the ICU. Read More » Welcome back to the tasty morsels of critical care podcast. I don’t think I’ve ever looked after a true myasthenic crisis in the ICU. Likely because.

Critical Care 40

Critical Care ICU ED OR 40

Critical Care Scenarios

NOVEMBER 15, 2020

Takeaway lessons Many decisions in the ED are less about what to do, and more about when to do it. Takeaway lessons * Many decisions in the ED are less about what to do, and more about when to do it. Time and location are key considerations for efficient care.* Goals of care starts in the ED, and not with lip service.

ICU 100

ICU Life Support Emergency Department ED 100

Emergency Medicine Ireland

OCTOBER 28, 2020

Welcome back to the tasty morsels of critical care podcast. TTP is a lovely ICU diagnosis. Read More » Welcome back to the tasty morsels of critical care podcast. TTP is a lovely ICU diagnosis. Not so much for the patient but it’s one of those ones that is niche enough to not have been picked up via the.

Critical Care 40

Critical Care Plasma FFP ICU 40

Emergency Medicine Ireland

JANUARY 28, 2021

Welcome back to the tasty morsels of critical care podcast. Cardiac pacing comes in a variety of flavours in critical care but a reasonable list of class I indications for permanent pacing might include: 2nd/3rd block with symptoms and bradycardia, Read More » Welcome back to the tasty morsels of critical care podcast.

Critical Care 40

Critical Care ICU OR ED 40

EMDocs

JUNE 22, 2024

A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. Treatment is supportive with respiratory therapy, critical care, inotropic therapy, and cardiac life support. We’ll keep it short, while you keep that EM brain sharp. She had a precipitous delivery while the ambulance was pulling in.

EMS 111

EMS FFP Ambulance ICU 111

Critical Care Scenarios

NOVEMBER 29, 2020

Looking at the workflow of a fresh post-op open heart surgery patient, as well as what to do when it devolves into cardiac tamponade, with (returning) guest Brendan Riordan, cardiothoracic ICU PA (@concernecus) at the University of Washington, and his NP colleague Kris Ramilo (@krsrml0). Audio quality was a bit dodgy in this one; sorry all!–eds.]

ICU 100

ICU Epinephrine OR ED 100

REBEL EM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. J Crit Care. Paper: Owyang CG, et al.

Emergency Department 52

Emergency Department ICU Critical Care EMR 52

Don't Forget the Bubbles

AUGUST 23, 2023

Very rarely are the ED team allowed to stand, in silence, with a purpose. 2018) “Sacred Pause Imitative in the ICU: A survey of ICU physicians and nurses”. Critical Care Medicine , 46 (1), pp. The Pause allows us to take the foot off the pedal briefly. Cunningham T. Southern Medical Journal. 112 (9),pp.

Emergency Department 98

Emergency Department ICU ALS Critical Care 98

Critical Care Scenarios

JULY 11, 2021

Our guest is trauma surgeon Dr. Dennis Kim ( @traumaicurounds ), associate professor of Clinical Surgery at UCLA and medical director of the Harbor-UCLA Medical Center SICU, as well as host of the Trauma ICU Rounds podcast. Traction splinting is usually not done in the ED.

Operating Room 100

Operating Room ICU ED OR 100

Don't Forget the Bubbles

JUNE 17, 2024

The Importance of Civility in Critical Care Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. The team sits down for a hot debrief once the patient is stabilised and transferred to the ICU. Conclusion Critical care resuscitation is stressful. Incivility can mean many things.

E-9-1-1 105

E-9-1-1 Critical Care CPR ICU 105

ACEP Now

OCTOBER 15, 2023

Intravenous insulin infusions typically require treatment in highly monitored settings, such as an intensive care unit (ICU) or step-down unit for safety and due to the frequency and intensity of monitoring. ICU and step-down beds are a limited resource and generate higher hospital charges. JAMA Netw Open. 2022;5(4):e226417.

ICU 80

ICU ALS ED Emergency Department 80

EMDocs

NOVEMBER 1, 2023

A 39-year-old male with history of achalasia with recent endoscopic dilation 24 hours prior presents to the ED for progressively worsening chest pain with radiation to his left shoulder. 4 Prompt consultation is imperative with thoracic surgery, interventional radiology (IR), gastroenterology (GI), and/or critical care.

Critical Care 93

Critical Care ED EMS OR 93

REBEL EM

JUNE 8, 2023

This study chose a relevant topic to analyze that could influence acute management in the ED and has a fairly larger sample size of patients to do so. The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. Intensive Care Med. J Med Toxicol. Epub 2019 Jul 3. 2018;44(6):857–67.

Epinephrine 98

Epinephrine Emergency Department ALS Critical Care 98

Critical Care Scenarios

APRIL 27, 2020

Takeaway lessons * We can undo most things except death, so in most cases, a short trial (perhaps 3 days) of fully aggressive care after an ICU admission is reasonable to help clarify the eventual prognosis. Set clear guideposts for when you’ll regroup to make more decisions about the direction of care.* See Part 2 here.

ICU 100

ICU ED OR 100

AAEM RSA

JUNE 30, 2021

1] Graduates of the combined degree may choose to work solely in either field, enter a subspecialty, pursue additional fellowship experience in critical care, or engage in research.[2] This path involves seventy-two months split between emergency medicine and internal medicine with additional experience in the critical care setting.[3]

EMS 52

EMS Critical Care ICU ED 52

ACEP Now

JULY 7, 2024

Alternatively, the Neurocritical Care Society defines it as a seizure with five minutes or more of continuous clinical or EEG seizure activity, or recurrent seizure activity without recovery between seizures. 1 History and physical examination have been the cornerstone of seizure diagnosis in the emergency department (ED).

Emergency Department 52

Emergency Department Critical Care ALS ICU 52

EMDocs

JANUARY 16, 2024

Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/critical care pod of your emergency department (ED). His blood sugar was normal en route to the ED, and his initial rhythm on the cardiac monitor was asystole. Per EMS he was very cold to touch.

Defibrillator 109

Defibrillator CPR Epinephrine Life Support 109

Don't Forget the Bubbles

AUGUST 28, 2023

You contact ICU, anaesthetics, ENT, and oncology with a plan to attempt more definitive imaging in the prone position (which Ginny tells you is much comfier) What’s the evidence for our emergent management? Arch Dis Child Educ Pract Ed. A CXR demonstrates a mediastinal mass. RadioGraphics. 2017;37(2):413-436.doi:10.1148/rg.2017160095

Emergency Management 97

Emergency Management Emergency Manager E-9-1-1 ICU 97

Broome Docs

MAY 31, 2024

Do we need to intubate French drunkards in ED? Justin and I discuss 7 papers covering a range of topics from securing IVCs in kids to intubating in space and the use of religious sham artifacts in middle-age, French “psychiatry” Yep, it was a strange month on the pod!

E-9-1-1 82

E-9-1-1 ED Critical Care ICU 82

EMOttawa

FEBRUARY 1, 2024

In our first part, we talked about the basics of mechanical ventilation and how to set up the ventilator for the busy ED doc! In part two, we discuss lung protective ventilation and go through a few cases to help solidify what we’ve learned.

ED 80

ED Critical Care ICU 80

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. EKG RV strain. Tintinalli, J.E.

ED 98

ED NARCAN ALS OR 98

REBEL EM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). 2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). Circulation , 5 Nov. 2, 2018, pp.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

ACEP Now

MARCH 13, 2024

Emergency departments (EDs) provide the essential service of evaluating patients with unscheduled, acute, undifferentiated, and decompensated conditions. ED crowding impairs this mission. The Emergency Medical Treatment and Labor Act (EMTALA) mandates examination, treatment, and stabilization of anyone who comes to the ED.

Emergency Department 52

Emergency Department ED ALS ICU 52

ACEP Now

MAY 9, 2024

JHS’ chart review project, which identified 163 patients presenting to the ED with gluteal AFT complications in a 30-month period between 2020 and 2023, provides one of the most comprehensive and informative datasets on the breadth of AFT complications as they are currently being performed. units per patient. References Garcia SE.

Emergency Department 52

Emergency Department Operating Room Critical Care ICU 52

REBEL EM

MAY 8, 2023

95% Confidence Interval) Strengths: The study addresses a patient-centered clinical question that is relevant to ED practice. 2,230 records remained after the elimination of duplicates. 2,210 records were excluded after screening. Researchers performed a full-text review of 20 publications. in ICC group, 5.8%

E-9-1-1 58

E-9-1-1 ICU Critical Care OR 58

Dr. Smith's ECG Blog

MAY 5, 2022

Submitted and written by Destiny Folk MD , peer reviewed by Meyers, Smith, Grauer, McLaren A man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. On arrival in the ED, he was hypotensive with a systolic blood pressure in the 70s.

E-9-1-1 52

E-9-1-1 OR STEMI ED 52

Dr. Smith's ECG Blog

JULY 12, 2020

While calling for some help and arranging to have her transported to our critical care zone, I got this quick ultrasound which confirmed my suspicion: This quick view was all I was able to obtain in the circumstances. The ED catheter was removed at that point and she did not require any further procedures.

E-9-1-1 40

E-9-1-1 ED STEMI OR 40

EMDocs

FEBRUARY 12, 2024

As the only respiratory therapist in the ED has been paged and is starting BiPAP for this patient, an overhead call for two incoming trauma alerts from a multivehicle collision sounds. Because the RT responsible for drawing arterial blood gases is busy caring for these patients, ABGs will be delayed.

Emergency Department 98

Emergency Department E-9-1-1 ED ICU 98

REBEL EM

NOVEMBER 11, 2024

found no difference in mortality in critical care patients treated with vancomycin and piperacillin- tazobactam compared to vancomycin and cefepime or meropenem. Imbalances Between Treatment Groups : ICU Admissions : Higher in piperacillin-tazobactam (33% vs. 30%). In 2021, Buckley et. 3 The same year, Ross et. vs. 52.2%).

E-9-1-1 113

E-9-1-1 ICU ALS Critical Care 113

EMDocs

JUNE 27, 2024

An 8-year old male with a history of sickle cell anemia presents to the ED for evaluation of fever for 2 days and “feeling like I can’t get a full breath”. 768: Epidemiology of Hospital Based ED Visits due to Sickle Cell Crisis and Acute Chest Syndrome in Kids. Critical Care Medicine 41(12):p A191, December 2013.

E-9-1-1 97

E-9-1-1 ICU ACS EMS 97