The Skeptics' Guide to EM

OCTOBER 3, 2021

Saline Solution on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial. 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. Lactated Ringer’s or Plasmalyte 148) over 0.9%

OR 130

OR Critical Care ICU Plasma 130

Emergency Medicine Ireland

MAY 13, 2024

Welcome back to the tasty morsels of critical care podcast. Part 1 will cover a broad overview of pulmonary hypertension and part 2 will focus on management strategies for a PH patient in the ICU. This time we’re looking at pulmonary hypertension. We’re going to try it as a 2 parter. This is by far the commonest.

Critical Care 98

Critical Care ICU OR 98

Critical Care Scenarios

MARCH 7, 2021

How to manage the intubated critically ill patient while keeping them awake, non-delirious, and mobile, with Dr. Dale Needham, FCPA, MD, PhD. Dr. Needham is a Professor of Pulmonary and Critical Care Medicine as well as Physical Medicine and Rehabilitation at the Johns Hopkins University. More fentanyl is often needed early on.

ICU 100

ICU Critical Care OR 100

EMDocs

JANUARY 11, 2024

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. Instead, target 92-98%. Keep hemoglobin > 7 g/dL. Treat seizures if present.

Critical Care 98

Critical Care E-9-1-1 OR ICU 98

Critical Care Scenarios

JANUARY 23, 2022

An overview of the role and contributions of a clinical pharmacist in the ICU, with Laura Means Ebbitt of the University of Kentucky, a clinical pharmacist specializing in colorectal/ENT surgery and critical care. Takeaway lessons A clinical pharmacist is a “knowledge pharmacist,” dispensing advice rather than medications.

ICU 130

ICU Critical Care OR 130

Critical Care Scenarios

OCTOBER 12, 2022

Emily Fridenmaker (@emily_fri), pulmonologist and intensivist at Charleston Area Medical Center in West Virginia. Continuing education for this episode CME credit provided courtesy of Academic CME. can be elevated by diuresis* Serum albumin/pleural > 1.2* Pleural LDH/serum LDH > 0.6* glucose <40 (or 60?) glucose <40 (or 60?),

ICU 130

ICU OR 130

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

The Effect of Vitamin C on Clinical Outcome in Critically Ill Patients: A Systematic Review with Meta-Analysis of Randomized Controlled Trials. Critical Care Medicine. The Effect of Vitamin C on Clinical Outcome in Critically Ill Patients: A Systematic Review with Meta-Analysis of Randomized Controlled Trials.

ICU 130

ICU Critical Care ALS Emergency Department 130

REBEL EM

OCTOBER 5, 2023

ClinicalTrials.gov: NCT02517489 7 Clinical Question: In adult patients with severe community-acquired pneumonia admitted to the ICU, does early hydrocortisone treatment, compared to standard therapy, reduce mortality at 28 days? Patients enrolled from 31 Intensive Care Units in France. in the hydrocortisone group vs. 11.9%

Critical Care 94

Critical Care ICU E-9-1-1 ALS 94

Critical Care Scenarios

JUNE 26, 2024

We discuss the field of rehabilitation psychology, and how it can help patients with persistent critical illness, with Dr. Megan Hosey (@DrMeganHoseyPhD), clinical psychologist and assistant professor at Johns Hopkins School of Medicine, where she practices in the medical ICU. Delirium often dominates the patient experience of the ICU.

ICU 169

ICU OR 169

Emergency Medicine Ireland

JULY 3, 2023

Welcome back to the tasty morsels of critical care podcast. This segues relatively nicely into a section of the document on palliative care. It is important to realise that a referral to ICU for refractory cardiorenal syndrome may simply be a sign that the patient is reaching end of life. With me so far?

Critical Care 96

Critical Care ACS OR ALS 96

Critical Care Scenarios

MAY 31, 2023

A brief overview and call to arms around the key concepts of ICU liberation. A brief overview and call to arms around the key concepts of ICU liberation.

OR 100

OR ICU 100

Emergency Medicine Ireland

JANUARY 4, 2021

Welcome back to the tasty morsels of critical care podcast. So, from the ultra broad topic of AKI in the last podcast to the super specific question of when we should pursue an open lung biopsy in an ICU patient. Read More » Welcome back to the tasty morsels of critical care podcast.

Critical Care 52

Critical Care ICU OR 52

Emergency Medicine Ireland

MAY 27, 2024

Welcome back to the tasty morsels of critical care podcast. Vasopressin has some animal data suggesting it causes less rise in PVR than our beloved noradrenaline but take that with an appropriately loosely defined portion of salt given that animal data is not ICU patients. In terms of monitoring should we be reaching for a PAC?

Critical Care 52

Critical Care ICU OR ALS 52

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. With both ER and ICU experience, this post acts as a quick […] The post Mechanical Ventilation Basics appeared first on EMOttawa Blog.

ICU 143

ICU ED OR Critical Care 143

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 Epinephrine 130

Emergency Medicine Ireland

MARCH 27, 2023

Welcome back to the tasty morsels of critical care podcast. Oh Chapter 37 is dedicated to NIV in the ICU and is probably worth some time given that this is a common respiratory support both in the ICU and throughout the hospital. On an ICU vent this would be described as 5/5. Still to be proven but commonly tried.

Critical Care 52

Critical Care ICU OR 52

Critical Care Scenarios

MARCH 27, 2022

Stephanie Martin (Twitter: @OBCriticalCare, Instagram: @criticalcareob), medical director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist in Scottsdale, Arizona with expertise in critical care obstetrics. She is also co-host of the Critical Care Obstetrics podcast. This is not the goal.*

Critical Care 100

Critical Care ICU CPR OR 100

Emergency Medicine Ireland

DECEMBER 14, 2020

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. This is a mammoth topic that listening to 5 mins of me rambling will in no way seriously prepare you to either practice clinically or write a semi coherent exam. That being said here we go.

Critical Care 40

Critical Care ICU OR 40

Emergency Medicine Ireland

FEBRUARY 18, 2021

Welcome back to the tasty morsels of critical care podcast. A meandering monologue through critical care fellowship exam preparation. HIV in the ICU is becoming a bit of a rare beast as the ID docs seem to have it so. Read More » Welcome back to the tasty morsels of critical care podcast.

Critical Care 40

Critical Care ICU OR 40

Critical Care Scenarios

JULY 17, 2022

Takeaway lessons * Invasive aspergillosis is among the most common diseases identified on autopsy studies of ICU patients that was not recognized prior to death. Infection in the ICU patient arises when there are abnormalities in the flow of fluid, anatomical barriers, and/or the immune defenses (particularly neutrophil function).*

ICU 100

ICU Critical Care OR 100

The Skeptics' Guide to EM

JUNE 22, 2024

Conservative versus liberal oxygenation targets in critically ill children (Oxy-picu): a UK multicentre, open, parallel-group, randomised clinical trial. Dr. Anireddy Reddy Case: A 3-year-old girl presents to the emergency department (ED) with fever and respiratory distress. But like many interventions, there are potential harms and benefits.

ICU 141

ICU Critical Care ALS Emergency Department 141

Critical Care Scenarios

DECEMBER 7, 2022

Signs of baseline and/or new RV strain, such as reduced TAPSE, septal bowing, etc, as well as pericardial effusion, suggest a poor reserve for the stresses of their new ICU course. Click here to claim your CME credit! Find us on Patreon here! Buy your merch here! Non-invasive cardiac output monitors are of questionable utility. *

ICU 100

ICU Critical Care Epinephrine OR 100

Emergency Medicine Ireland

MARCH 7, 2022

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. However in ICM there is a need to have a broad understanding of what some of the haematological acronyms might mean given that a fair number of these patients end up in the ICU.

Critical Care 52

Critical Care Plasma ICU OR 52

Critical Care Scenarios

MAY 16, 2021

The art of taking a critically ill, heavily sedated, floridly delirious patient on aggressive vent support and pulling them out of the loop of sedation, immobility, and delirium. A spiritual successor to our talk with Dale Needham , this time focusing more on details and practical approaches. .* Limited activity is better than none.

ICU 100

ICU Critical Care OR 100

Emergency Medicine Ireland

DECEMBER 3, 2020

Welcome back to the tasty morsels of critical care podcast. As an EM trainee doing intensive care I will confess that I struggle to work up the enthusiasm to cover a nutrition guideline. Read More » Welcome back to the tasty morsels of critical care podcast. As with all ICU nutrition EN is preferred over PN.

Critical Care 52

Critical Care ICU EMS OR 52

Emergency Medicine Ireland

APRIL 19, 2021

Welcome back to the tasty morsels of critical care podcast. A meandering monologue through critical care fellowship exam preparation. Read More » Welcome back to the tasty morsels of critical care podcast. A meandering monologue through critical care fellowship exam preparation.

Critical Care 52

Critical Care ICU Overdose OR 52

Emergency Medicine Ireland

OCTOBER 14, 2024

Welcome back to the tasty morsels of critical care podcast. The major barrier to implementation in the ICU setting is the almost complete absence of ICU patients from these trial cohorts. Welcome back to the tasty morsels of critical care podcast. Many penumonias will develope a parapneumonic effusion.

Critical Care 52

Critical Care ICU ALS OR 52

Emergency Medicine Ireland

SEPTEMBER 20, 2021

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. After 2 years of frequent, if not daily use of the bronch, I find it hard to see how I would manage in an ICU without it. Why might we pull out the bronch in the ICU?

Critical Care 40

Critical Care ICU EMS OR 40

Core EM

JANUARY 25, 2024

Disposition to ICU. Experts consensus recommendations for the management of calcium channel blocker poisoning in adults: Critical Care Medicine. Supplement additional dextrose prn, if hypoglycemia occurs do not stop the insulin, increase the rate of the dextrose drip. References: Yuan TH, Kerns WP, Tomaszewski CA, et al.

Overdose 246

Overdose Epinephrine ALS ICU 246

Critical Care Scenarios

AUGUST 8, 2021

Back in the arena with one of our favorites, Matt Siuba (@msiuba), Cleveland Clinic intensivist and Mr. Zentensivism, to discuss complications in critical care and how to prevent and manage them. Takeaway lessons * Rapid atrial fibrillation in the ICU should be considered a “symptom,” not a disease per se.

ICU 100

ICU Critical Care OR 100

Critical Care Scenarios

NOVEMBER 1, 2020

A look at oncology-related emergencies in the ICU, with Leon Chen (@CCMNP), NYC nurse practitioner specializing in oncology critical care. This can be resolved with whole blood samples or point-of-care assays, which decrease transport time and sample agitation.* Pulse oximetry is more reliable.*

ICU 100

ICU Critical Care OR 100

ALiEM

MAY 19, 2023

In our emergency department, the RTs do not spend a lot of time going around measuring cuff pressures and usually save that until the patient reaches the ICU. Another minor difference is that the gastric balloon in the Minnesota tube holds 450-500 ccs of air, while the SB gastric balloon holds 250 ccs of air [2].

E-9-1-1 245

E-9-1-1 Emergency Department ICU OR 245

Emergency Medicine Ireland

JANUARY 14, 2021

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. We all get excited about CMV but in reality this is not often an ICU issue in the post transplant period and comes later on often at the 3-4 week mark. Part 1 lives here.

Critical Care 52

Critical Care ICU OR 52

Emergency Medicine Ireland

JUNE 7, 2021

Welcome back to the tasty morsels of critical care podcast. It is with trepidation that I approach any topic that involves the negative feedback loops of endocrine control as I really struggle to keep it all straight in my head, Read More » Welcome back to the tasty morsels of critical care podcast.

Critical Care 52

Critical Care Plasma ICU OR 52

Emergency Medicine Ireland

JANUARY 18, 2021

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. Like most spaces within the body, the contents within the cranium are under a certain degree of pressure. The skull being a rigid box can accommodate pressure much less than.

Critical Care 52

Critical Care ICU OR 52

Emergency Medicine Ireland

MAY 30, 2022

Welcome back to the tasty morsels of critical care podcast. Today we’re going to talk about some of the basics of some of our favorite drugs intensive care – the diuretics. As always this is planned to be a brief overview of the essentials rather than the deep dive. Lose the Na and the water will follow.

Critical Care 52

Critical Care ICU OR 52

Emergency Medicine Ireland

MARCH 15, 2021

Welcome back to the tasty morsels of critical care podcast. A meandering monologue through critical care fellowship exam preparation. Today’s podcast is mostly taken from Oh’s manual Chapter 96 covering critical care nutrition. Read More » Welcome back to the tasty morsels of critical care podcast.

Critical Care 40

Critical Care ICU OR 40