Core EM

JANUARY 25, 2024

The standard of care of treating DKA is fluid resuscitation, electrolyte management, and intravenous insulin infusion in the intensive care unit (ICU) setting for close glucose and electrolyte monitoring. Recent research aims at investigating the treatment of DKA with subcutaneous insulin in non-ICU settings. Image from cited article.

EMS 246

EMS ICU ED OR 246

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?” However, the ICU is full and the patient will likely be boarding in your ED for a bit before coming upstairs.

ICU 274

ICU ED Critical Care ALS 274

Critical Care Scenarios

OCTOBER 16, 2024

We discuss the practical barriers to implementing the A-F ICU liberation bundle, with Kali Dayton, ACNP-BC (@HomeIcu), host of the Walking Home from the ICU podcast, and consultant to ICUs working on these issues. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! Find us on Patreon here!

ICU 205

ICU 205

Critical Care Scenarios

DECEMBER 12, 2021

Bryan and Brandon talk about the physical exam: how we apply it in the ICU, its utility and changing role in the setting of modern diagnostic modalities, and its best and most practical use-cases. References McNamara LC, Kanjee Z. Counterpoint: Routine Daily Physical Exams Add Value for the Hospitalist and Patient. J Hosp Med. J Hosp Med.

ICU 100

ICU 100

Critical Care Scenarios

OCTOBER 12, 2022

To claim your CME … Continue reading "Episode 52: Pleural effusions in the ICU with Emily Fridenmaker" Discussing pleural effusions in the critically ill, including how and when to drain them, methods of drainage, interpreting laboratory studies, and managing complications, with Dr.

ICU 130

ICU OR 130

Critical Care Scenarios

FEBRUARY 6, 2022

Brandon and Bryan talk about the practicalities of communication, collaboration, and compromise in a surgical ICU, when the surgical and critical care teams are both involved, one is the “primary” team on paper, but everyone needs to be heard.

ICU 100

ICU Critical Care 100

EMCrit Project

APRIL 25, 2023

However, it also causes a variety of unique and severe side-effects, which frequently cause ICU admission. CAR-T cell therapy is rapidly expanding as a miraculous therapy for numerous malignancies.

ICU 95

ICU 95

EMDocs

DECEMBER 18, 2024

fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

E-9-1-1 105

E-9-1-1 Emergency Department ICU ED 105

Critical Care Scenarios

MARCH 7, 2021

He is also director of their Outcomes After Critical Illness … Continue reading "Episode 26: ICU sedation, mobility, and delirium with Dale Needham" How to manage the intubated critically ill patient while keeping them awake, non-delirious, and mobile, with Dr. Dale Needham, FCPA, MD, PhD.

ICU 100

ICU Critical Care OR 100

Life in the Fastlane

AUGUST 20, 2024

James Pearlman Introduction to an ICU rotation Introduction to an ICU rotation. This page is intended as an introduction to ICU core topics why the author enjoys Intensive Care Medicine

ICU 59

ICU 59

Don't Forget the Bubbles

MARCH 21, 2025

Effectiveness of Nasal High-Flow Oxygen during apnoea on Hypoxaemia and Intubation Success in Paediatric Emergency and ICU Settings: a randomised, controlled, open-label trial. Its pragmatic design ensured that a broad range of clinical presentations were included across the ED and ICU settings. Thats exactly what Shane George et al.

ICU 103

ICU Critical Care ED OR 103

The Skeptics' Guide to EM

JULY 27, 2024

All of the secondary outcomes (mortality at 90 days, misdiagnoses, hospital length of stay, ICU admission rate, ICU length of stay, and quality of life) also did not show a statistical difference between the intervention group and the control group (SGEM#207).

ICU 246

ICU ALS Ambulance OR 246

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 166

ICU OR 166

Core EM

JANUARY 1, 2025

Supportive Care Intensive monitoring, often in an ICU setting. Adjunct Therapies Hyperbaric Oxygen Therapy (if available) for resistant cases. Evidence is mixed; not universally accessible. Fluid resuscitation & vasopressors for septic shock.

Critical Care 130

Critical Care ICU OR 130

The Skeptics' Guide to EM

APRIL 27, 2024

Date: April 25, 2024 Guest Skeptic: Missy Carter is a PA working in an ICU in the Tacoma area and an adjunct faculty member with the Tacoma Community College paramedic program. Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation.

ICU 231

ICU Defibrillator Paramedic CPR 231

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

REBEL EM

AUGUST 7, 2023

Background Information: Delirium is a common and serious condition in patients in the intensive care unit (ICU). It is estimated to affect 30-50% of patients in the ICU and haloperidol is the most frequently used agent in treatment (3). Paper: Andersen-Ranberg NC,et al; AID-ICU Trial Group. N Engl J Med. 2022 Dec 29.

ICU 52

ICU ALS OR EMS 52

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 ).

ICU 246

ICU Emergency Department Critical Care ALS 246

EMCrit Project

JANUARY 15, 2024

Who gets an ICU bed? EMCrit Project by Scott Weingart, MD FCCM.

ICU 74

ICU 74

The Bottom Line

APRIL 21, 2023

In patients in the ICU with delirium, does haloperidol compared with placebo, increase the number of days alive and out of the hospital at 90 days?

ICU 52

ICU 52

Critical Care Scenarios

OCTOBER 2, 2024

We chat with Noelia Bischoff, recently off orientation in the medical ICU at Johns Hopkins as a nurse practitioner, about the transition from her role as a bedside ICU nurse. Check out the Intensive Care Academy here! Find us on Patreon here! Buy your merch here! Check out the Intensive Care Academy here! Find us on Patreon here!

ICU 122

ICU 122

Critical Care Scenarios

FEBRUARY 14, 2024

Resources * ICU Liberation.org * ICU Delirium * ICU Rehab Network Resources A roundup of opinions from attendees at SCCM’s 2024 Critical Care Congress in Phoenix on strategies for rescuing the patient stuck in a loop of deep sedation and agitation.

ICU 133

ICU Critical Care 133

EMOttawa

OCTOBER 24, 2024

Historically, it has been used more frequently in the ICU than in Emergency Departments, likely due to provider comfort. […] The post Is there a Precedence for Precedex in the ED? It offers a unique profile of sedation without respiratory depression, making it an attractive option in various clinical scenarios.

ED 125

ED Critical Care ICU Emergency Department 125

EMCrit Project

JANUARY 30, 2024

Polypharmacy is technically defined as taking five or more medications on a daily basis. Polypharmacy is increasingly becoming the norm among adults, due to several factors (an aging population, increasing numbers of medical problems, and increasingly complex regimens available to treat chronic disorders such as heart failure).

ICU 105

ICU OR 105

REBEL EM

FEBRUARY 15, 2024

PMID: 38019968 Clinical Question: In patients with suspected acute poisoning and GCS <9, is a conservative airway strategy of withholding intubation associated with a reduction in death, ICU LOS, and hospital LOS compared with routine practice of intubation? References: Freund Y et al.

ICU 139

ICU ALS ED OR 139

The Skeptics' Guide to EM

MAY 25, 2024

This is based, in large part, on indirect evidence illustrating the benefits of adjunctive phenobarbital including, but not limited to, reduction on the need for intubation, decreased hospital length of stay, decreased ICU admission and length of stay.

ED 252

ED Emergency Department ICU ALS 252

EMCrit Project

SEPTEMBER 28, 2023

background Today the Van de Bergh group in Belgium released a RCT investigating tight versus liberal glycemic control in the ICU. Major interest in tight glycemic control in the ICU began in 2001 with an RCT by the same group of investigators, also […] EMCrit Project by Josh Farkas.

ICU 128

ICU 128

EMCrit Project

APRIL 13, 2024

10 heuristics for the new Crit Care doc from Ross Prager EMCrit Project by Scott Weingart, MD FCCM.

ICU 96

ICU 96

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

ALiEM

JUNE 1, 2023

Several studies have indicated that dosing with phenobarbital (PO or IV) is safe and effective at decreasing the need for escalating doses of benzodiazepines for EtOH withdrawal [1-6].

Emergency Department 246

Emergency Department ICU ED OR 246

The Skeptics' Guide to EM

SEPTEMBER 28, 2019

Case: A 45-year-old female in the emergency department is being admitted to the intensive care unit (ICU) for septic shock secondary to urinary tract infection (UTI). You are ready to call the ICU and get her admitted. But you remember seeing in the news there was a study claiming vitamin C could cure sepsis. Reference: Putzu et al.

ICU 130

ICU Critical Care ALS Emergency Department 130

Critical Care Scenarios

SEPTEMBER 27, 2023

Leon is an Adult/Gerontology Acute Care Nurse Practitioner in the ICU, Clinical Program Manager of Research and Simulated Learning, and an Associate Professor at Columbia University School of Nursing. We chat with Leon Chen about his work setting up infrastructure for clinical POCUS at Memorial Sloan Kettering. Find us on Patreon here!

ICU 130

ICU Critical Care 130

EMCrit Project

SEPTEMBER 3, 2023

Consequently, a single person will often be responsible for both inpatient ICU management as well as inpatient pulmonary consultation. In many countries, pulmonary and critical care are commonly bundled together. Honestly, I have some doubts about whether this is an ideal system.

Critical Care 140

Critical Care ICU 140

EMCrit Project

AUGUST 26, 2022

It is unacceptable to have the rates of Awareness during Paralysis seen in a recent ED sedation study--We are better than this. EMCrit Project by Scott Weingart, MD FCCM.

ICU 100

ICU ED 100

EMCrit Project

JUNE 18, 2024

I would view this as the triquel following SUP-ICU and PEPTIC. In order to understand REVISE in context, let's briefly review SUP-ICU and PEPTIC trials, before discussing REVISE. Part I: SUP-ICU (2018) This was a large multicenter RCT […] EMCrit Project by Josh Farkas.

ICU 96

ICU 96

REBEL EM

JANUARY 18, 2024

PMID: 35387313 Clinical Question: Do prehospital antibiotics impact 28 day mortality, length of stay in the hospital and ICU length of stay for patients triggering sepsis compared to usual care (No prehospital antibiotics)? to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26 to 0.97; p = 0.02 to 2.07; p = 0.91 to 12.33; p = 0.26

ICU 130

ICU ALS EMS 130

ACEP Now

OCTOBER 13, 2023

Our residents are currently the primary staff members in our Shoreline emergency department, had of the medical ICU, and the entire Trauma ICU. “We feel that this decision was made without adequate assessment of the negative impacts this WILL have on our patients.

ICU 132

ICU Emergency Department EMS 132