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

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 74

Critical Care E-9-1-1 OR ICU 74

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

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

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

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

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

JUNE 10, 2024

Welcome back to the tasty morsels of critical care podcast. We’re much less likely to see this cohort in the critical care side of things. A follow up trial in 2011 by ICU steroid guru Djilalli Annane did not find a benefit. Intensive Care Medicine 37 , 486–492 (2011). This is not really our cohort.

Critical Care 52

Critical Care EMS ALS ICU 52

Emergency Medicine Ireland

JANUARY 22, 2024

Welcome back to the tasty morsels of critical care podcast. Today we’ll cover some key exam content, all be it not something you’re likely to run into in the ICU too often. The thyroid is a deceptive little organ, tucked in the neck, quietly secreting hormones and interfering in negative feedback loops.

Critical Care 52

Critical Care Organ Donor ICU OR 52

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

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 OR EMS 40

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

Core EM

JANUARY 25, 2024

The reality of ever increasing ED volumes and longer boarding times to the ICU makes it imperative for emergency physicians to learn how to manage these critical patients. It was found that patients exposed to deep sedation in the ED had an independent higher incidence of continued deep sedation on ICU day one ( Fuller, 2019 ).

Emergency Department 246

Emergency Department ICU Critical Care ALS 246

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

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

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

Emergency Medicine Ireland

OCTOBER 16, 2023

Welcome back to the tasty morsels of critical care podcast. The incidence of dynamic LVOTO in those with septic shock is remarkably high and is reported to be 20% in one study from ICU echo guru Michel Slama. References Chapter 13, Oxford Textbook of Advanced Critical Care Echocardiography covers this nicely.

Critical Care 52

Critical Care ICU OR ALS 52

Emergency Medicine Ireland

MARCH 13, 2023

Welcome back to the tasty morsels of critical care podcast. Today we’re covering the ambitious topic of CRRT in the ICU. The final ICU specific mode of RRT is probably SLED. We’re only going to get so far as the modes today so let’s not get too carried away. Slow, Low efficiency Dialysis.

Critical Care 52

Critical Care Plasma ICU OR 52

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The patient states he has had multiple “diabetic emergencies” in the past and usually ends up in the intensive care unit (ICU) on a drip. He is wondering, “Hey doc, do I have to go back to the ICU strapped to an IV pole?” They are on the phone asking you if you already have another admission for them on this busy day.

ICU 201

ICU ED Critical Care ALS 201

Emergency Medicine Ireland

SEPTEMBER 18, 2023

Welcome back to the tasty morsels of critical care podcast. I don’t deny that albumin has a limited role in the ICU, gone are the days where we could make bold assertions about colloid osmotic pressures and how albumin was better than crystalloid. To start with we need context. This is all about timing of onset.

Critical Care 52

Critical Care ICU OR 52

Emergency Medicine Ireland

AUGUST 1, 2022

Welcome back to the tasty morsels of critical care podcast. Diagnosis and management of infections with this bug are a common occurence in the ICU and it behoves us to have a working knowledge of some of the complexities of its investigation and treatment that often fall to our micro or ID colleagues.

Critical Care 40

Critical Care ICU OR 40

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

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

Emergency Medicine Ireland

FEBRUARY 6, 2023

Welcome back to the tasty morsels of critical care podcast. Given that a lot of ICU bed days are given over to managing SAH, I felt it might have warranted its own chapter. Though i’ll admit that that question is delving much more into the realm of EM than hard core crit care. What pray tell is this new calamity?

Critical Care 52

Critical Care ICU EMS OR 52

Emergency Medicine Ireland

OCTOBER 30, 2023

Welcome back to the tasty morsels of critical care podcast. Enrolled 800 fairly typical ICU patients, and found a 35% vs 39% mortality benefit favouring the vaso but of course this was below the somewhat arbitrary statistical significance. Intens Care Med 45 , 844–855 (2019). How does it work? How does it work?

Critical Care 52

Critical Care ALS Coronary ICU 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

JANUARY 10, 2022

Welcome back to the tasty morsels of critical care podcast. We see a number of fungal infections in the ICU, most commonly it’ll be the yeasts – forms of candida. Read More » Welcome back to the tasty morsels of critical care podcast. Today we look at everyone’s favorite mould – aspergillus.

Critical Care 40

Critical Care ICU OR 40

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

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

MAY 16, 2022

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. I suspect that’s largely due to better access and provision of primary care but there remains a cohort of fairly brittle folk out there who will occasional crop up in resus or the ICU.

Critical Care 40

Critical Care ICU OR EMS 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

Emergency Medicine Ireland

FEBRUARY 25, 2021

Welcome back to the tasty morsels of critical care podcast. A meandering monologue through critical care fellowship exam preparation. Diff in the ICU in a couple of contexts. Read More » Welcome back to the tasty morsels of critical care podcast. Diff in the ICU in a couple of contexts.

Critical Care 40

Critical Care ICU OR 40

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

MARCH 22, 2021

Welcome back to the tasty morsels of critical care podcast. A meandering monologue through critical care fellowship exam preparation. ICU level pre eclampsia is. Read More » Welcome back to the tasty morsels of critical care podcast. ICU level pre eclampsia is rare. Firstly some definitions.

Critical Care 40

Critical Care ICU OR 40

Emergency Medicine Ireland

APRIL 4, 2022

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. As such it presents a fairly predictable work load and patient cohort for your ICU. At least it was pre-pandemic anyhow.

Critical Care 40

Critical Care ICU OR 40

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

JULY 26, 2021

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. Candidiasis is common in ICU patients. These are work horses in the ICU with a low side effect profile and importantly cover the vast majority of candida likely to grow.

Critical Care 40

Critical Care ICU OR 40