Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Many providers and health care workers place oxygen on patients as a way to overcome hypoxemia or for patient comfort. Also in STEMI patients, many of us have learned the mnemonic “MONA” to remember the treatments for acute coronary syndrome. MONA stands for morphine, oxygen, nitroglycerin, and aspirin. […]
Archive for category: Critical Care
Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Acutely agitated and aggressive patients have become an unfortunate commonality in emergency departments throughout the world. They are often the most difficult patient encounters during a shift. Initially, when these patients’ present, medical providers are trying to figure out the underlying etiology including organic, psychiatric, or drug related illness. […]
Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Intraosseous (IO) access can play an important role in the resuscitation of the critically ill patient to help expedite delivery of critical medications (i.e. RSI). Much like with peripheral or central access, obesity can present a challenge to placement of an IO as accurate placement relies on use of […]
Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Anyone who has run a code, knows that pulseless electrical activity (PEA) during cardiac arrest has a worse prognosis compared to patients with shockable rhythms. In patients with suspected massive PE as the cause of their cardiac arrest the Advanced Cardiac Life Support (ACLS) and American Heart Association […]
Cardiac Arrest, Return of Spontaneous Circulation (ROSC) With No ST-Segment Elevation on ECG. Now What?
Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: The American Heart Association/American College of Cardiology (AHA/ACC) give a Class I recommendation for activation of the cardiac catheterization lab in patients with out-of-hospital cardiac arrest (OHCA) whom ST-segment elevation myocardial infarction (STEMI) is present. The evidence for early cardiac catheterization in patients after cardiac arrest, with ROSC […]
Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: For many emergency providers, POCUS has become a critical modality in the resuscitation of patients with cardiac arrest. The authors of this paper (The REASON Trial) state that <8% of all OHCA’s survive to hospital discharge; a dismal number. We already know that shockable rhythms, early defibrillation, early […]
Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketThe use of therapeutic hypothermia (TH) has become part of the routine care of patients after return of spontaneous circulation (ROSC) from cardiac arrest (Use of the phrase Targeted Temperature Management has become more accepted). It became much more accepted after two separate trials were published in the New […]
Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: The most recent surviving sepsis campaign recommends the use of hydrocortisone in patients with refractory septic shock (i.e. vasopressor dependent). However, the use of hydrocortisone in severe sepsis without shock still remains a very controversial topic. Recommendations for hydrocortisone are mostly based on 2 randomized clinical trials (i.e. […]
Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketDefinition: A dysfunctional condition in which removal of baclofen, an inhibitory neurotransmitter, from the central nervous system (CNS) causes CNS excitation.
Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Syncope is a very frustrating chief complaint for many in the medical field. There is no gold standard test and no validated decision instrument. It represents about 3 – 5% of ED visits, 1 – 6% of hospital admissions, and in patients over the age of 65 years […]