Archive for category: Critical Care

Peri-Intubation Anaphylaxis

08 May
May 8, 2017

Background: Peri-operative anaphylaxis is an unexpected complication of intubation. The major life threat in anaphylaxis is typically loss of airway, however profound hypotension and circulatory collapse are still possible life threats even in the setting of a protected airway. Peri-operative anaphylaxis is considered an important enough issue to be the subject of the NAP 6 (National Audit […]

Episode 37 – Definitions and Identification of Sepsis: Sepsis 2.0 vs Sepsis 3.0

01 May
May 1, 2017

Background: Just a few months ago the surviving sepsis campaign published their international guidelines for management of sepsis and septic shock [1].  There has been a lot of talk in the FOAM world about sepsis 3.0 and this is the first update since the introduction. This was a 67 page document that made a total […]

In-Hospital Cardiac Arrest: The First 15 Minutes

27 Apr
April 27, 2017

Background: Over the past few years there has been a shift in cardiac arrest from the mantra of ABC (Airway, Breathing, Circulation) to CAB (Circulation, Airway, Breathing).  There has been increased emphasis on circulation and a de-emphasis of airway management in cardiac arrest.  Physiologically, this makes sense as the only two interventions in cardiac arrest […]

Post Intubation Hypotension: The AH SHITE mnemonic

20 Apr
April 20, 2017

You have just secured the endotracheal tube following an uneventful intubation of a moderately ill  patient in your emergency department. They had a normal pre-intubation blood pressure.  As you are calling the admit in to the ICU the patient’s nurse tells you that the BP is now in the 70’s. NOW WHAT? Blindly give a half gallon […]

The Marik Protocol: Have We Found a “Cure” for Severe Sepsis and Septic Shock?

07 Apr
April 7, 2017

Background: The overall mortality in sepsis has decreased quite a bit in the last decade or so, however for a subset of patients, like those with Septic Shock, the mortality still remains high (as high as 50%).  There have been hundreds of studies trying to identify the holy grail to decrease mortality further, but one […]

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