March 20, 2020

On Feb 21st, a patient by the name of Aldo, a 72-year-old male, came to our ED with fever and progressive dyspnea. In addition, his chest x-ray showed an interstitial pattern. It was on this day that COVID19 had arrived in our emergency department… In this post we will describe how we responded to the COVID19 challenge, the impressive number of patients seen in just a few days’ time and some suggestions to prepare your emergency department for the future.

March 19, 2020

Background: Vasopressors are often used to improve hypotension and perfusion in an effort to decrease mortality of patients with septic shock. Mean arterial pressure (MAP) of >65mmHg has typically been used to guide vasopressor therapy in most patients and higher targets have been recommended for patients with chronic hypertension or coronary artery disease. Results from the Sepsis and Mean Arterial Pressure (SEPSISPAM) [2] and Optimal Vasopressor Titration (OVATION) [3] pilot trials suggested that increased exposure to vasopressors targeting higher MAPs in older patients (≥65mmHg) may be associated with increased risk of death. We now have the 65 trial [1] which is a randomized clinical trial testing the hypothesis that reducing vasopressor exposure through permissive hypotension (Targeting a MAP of 60 – 65mmHg) among patient ≥65 years of age with vasodilatory hypotension versus usual care in the ICU.

March 18, 2020

In light of COVID19, many medical institutions are cancelling not only international and domestic travel, but any gatherings of greater than 20 people.  This is leaving residency program leadership across the country scrambling to look for remote video conferencing options to deliver online didactic education.  In this article, we will review some of the options that you might consider to host such meetings, with a particular focus on suggestions for weekly resident conference.

March 16, 2020

Traditionally, endotracheal intubation has been the gold standard for airway management in cardiac arrest. However, more recent data suggests that maybe less is more (i.e. supraglottic airways and/or bag valve mask ventilation).  The AHA guidelines have also de-emphasized airway management as the old acronym of ABC's has now been changed to CAB's.  In this talk from Rebellion in EM 2019, Dr. Chris Hicks, MD discusses the optimal airway management in OHCA.

REBEL Review 96: CCB and BB Toxicity Review and Management

Created March 14, 2020 | Toxicology | DOWNLOAD