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

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

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 85

ICU 85

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 142

ICU ED OR Critical Care 142

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

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 196

ICU ED Critical Care ALS 196

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

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 52

ICU 52

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

EMCrit Project

JANUARY 15, 2024

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

ICU 68

ICU 68

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 136

ICU Critical Care 136

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 124

ICU 124

The Skeptics' Guide to EM

NOVEMBER 16, 2024

These systems use real-time data from electronic health records (EHRs) and other sources to predict which patients are at risk of adverse outcomes, such as cardiac arrest or transfer to an intensive care unit (ICU) [1.2]. Despite the potential benefits, integrating AI into clinical workflows presents challenges.

ICU 215

ICU Emergency Department ALS EMS 215

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 141

ICU ALS ED OR 141

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 185

ICU Defibrillator CPR Paramedic 185

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 122

ED Critical Care ICU Emergency Department 122

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 183

ICU ALS Ambulance OR 183

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 93

ICU OR 93

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

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 132

ICU ALS EMS 132

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

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

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 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 116

ICU 116

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 99

ICU ED 99

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 133

Critical Care ICU 133

EMCrit Project

APRIL 13, 2024

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

ICU 87

ICU 87

REBEL EM

FEBRUARY 29, 2024

3, 4 It is the most common nosocomial infection in patients on mechanical ventilation, and one of the leading causes of nosocomial infection among all patients in the ICU. The low incidence could be a result of the systematic implementation of bundles known to decrease VAP incidence in the ICU. 4, 8 Paper: Dahyot-Fizelier, C.,

E-9-1-1 125

E-9-1-1 ICU OR ALS 125

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

Emergency Medicine Education

OCTOBER 10, 2023

A recent prospective study was published in CHEST regarding the use of peripheral administration of Norepinephrine in ICU. 603 patients received medication through peripheral IV access, and they found almost half of patients did not require central access, and 35 patients had extravasation with no significant complications. Link to article

ICU 40

ICU Critical Care 40

REBEL EM

FEBRUARY 19, 2024

PMID: 37611862 Clinical Question: In patients treated in the ICU, can a protocol of peripheral IV catheter vasopressors safely reduce the number of days of CVC use and frequency of placement?

ICU 137

ICU EMS ALS OR 137

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

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

Critical Care Scenarios

JULY 10, 2022

Time is always a factor in the ICU, but some time matters more than other time. Time is always a factor in the ICU, but some time matters more than other time.

ICU 100

ICU 100