Archive for category: Critical Care

Is Fever the New Hotness in Sepsis?

28 Mar
March 28, 2017

Background: With the introduction of sepsis 3.0, came the quick sepsis related organ failure assessment (qSOFA) score. The purpose of this score is supposed to be a bedside tool to help predict which patients are at the greatest risk of poor outcomes.  There are three components to this score: Low systolic blood pressure (≤100mmHg), high […]

Altitude Adjusted PERC Oxygen Saturation

27 Mar
March 27, 2017

The PERC rule has been a welcome addition to the emergency department evaluation of patients with chest pain or dyspnea suspected of pulmonary embolism. This has allowed a reduction in D-dimer testing in low risk patients. The traditional saturation cut-off of 95% can pose a challenge for patients seen at higher elevations where mild hypoxemia can […]

Episode 34 – The Death of Mechanical CPR (mCPR)?

23 Mar
March 23, 2017

Background: The two most important things that we can do in cardiac arrest to improve survival and neurologically intact outcomes is high quality CPR, with limited interruptions and early defibrillation. In the case of the former, the 2015 AHA/ACC CPR updates recommended a compression rate of 100 -120/min, a depth of 2 – 2.4in, allowing full […]

The Benefit of Lung Protective Ventilation in the ED Should be LOV-ED

13 Mar
March 13, 2017

Background: Intubation and mechanical ventilation are commonly performed ED interventions and although patients optimally go to an ICU level of care afterwards, many of them remain in the ED for prolonged periods of time. It is widely accepted that the utilization of lung protective ventilation reduces ventilator-associated complications, including acute respiratory distress syndrome (ARDS). Additionally, […]

Fluid Responsiveness and the Six Guiding Principles of Fluid Resuscitation

27 Feb
February 27, 2017

Background: Fluid resuscitation is a crucial aspect of emergency and critical care. Since the advent of the concept of early goal-directed therapy, we have placed a huge emphasis on aggressive fluid resuscitation in patients with severe sepsis and septic shock. From EGDT to PROCESS/ARISE/PROMISE to Surviving Sepsis Guidelines, we have seen a shift in how fluid […]

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