Archive for category: Clinical

Simplifying Mechanical Ventilation – Part 2: Goals of Mechanical Ventilation & Factors Controlling Oxygenation and Ventilation

18 May
May 18, 2018

In part 1, we discussed that the ventilator can deliver 3 types of breaths: controlled, assisted or spontaneous breaths. These breaths can be delivered either by a set pressure or a set tidal volume. Then we closed with a discussion of the common ventilator modes, which is simply just combining all these types of breaths […]

Salicylate Toxicity

17 May
May 17, 2018

Definition: Salicylate toxicity is characterized by a constellation of symptoms caused by acute or chronic overdose of salicylate containing compounds. The most common salicylate is aspirin, but the group also includes topical forms of salicylates, methyl salicylate (Oil of Wintergreen), and bismuth subsalicylate (such as in Pepto-Bismol).

Wernicke Encephalopathy

14 May
May 14, 2018

Definition: Encephalopathy that occurs secondary to thiamine (vitamin B1) deficiency. While Wernicke encephalopathy is reversible with treatment, it can progress to the irreversible Korsakoff’s syndrome if left untreated.

Abscess Management: The Reformation of an Antibiotic Nihilist

12 May
May 12, 2018

Abscess management has evolved somewhat in the 14 years since my residency graduation. The point at which antibiotics are likely to be more helpful than harmful is not always easy to assess, and evidence based expert opinion has flip flopped impressively. Based on current evidence, I would like to answer 3 big questions that every […]

RSI, Predictors of Cardiac Arrest Post-Intubation, and Critically Ill Adults

10 May
May 10, 2018

Background:Intubation is a commonly performed procedure in the ED and ICU. We have discussed the physiologically difficult intubation before on REBEL EM.  One of the tenants in managing these patients is “resuscitate before you intubate.”  Two publications in the past [1][2] discussed the incidence and risk factors associated with cardiac arrest complicating RSI.  In the first […]

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