Background: Community acquired pneumonia (CAP), defined as lower bronchial tree infection in a patient that has not been hospitalized in the last 90 days is a commonly diagnosed disease. There are between 2-4 million episodes per year in the US with roughly ...
Background: In recent years, ketamine use has dramatically increased in the Emergency Department (ED). There are four major indications for the use of ketamine in the ED: analgesia with low dose ketamine (LDK), induction for rapid sequence intubation, procedural sedation ...
Refractory Hypoxemia: Now maybe you have intubated a patient secondary to hypoxemic respiratory failure who is at high risk for the development of acute respiratory distress syndrome (ARDS). These patients, and really all patients, with exception of severe obstructive disease, I ...
Background: Ureteric (renal) colic is a common, painful condition encountered in the Emergency Department (ED). Sustained contraction of smooth muscle in the ureter as a kidney stone passes the length of the ureter leads to pain. The majority of stones ...
Background: Pulseless electrical activity (PEA) is an organized electrical activity without a palpable pulse. 1/3 of cardiac arrest cases will be pulseless electrical activity and the overall prognosis of these patients is worse than patients who have shockable rhythms (ventricular fibrillation ...
Background: Emergency intubation in the ED is a potentially life-saving procedure in critically ill patients, but does have risks associated with it as we have discussed before on this blog. The authors of the study we are going to review today described ...
Obstructive Physiology: Setting up the ventilator for a patient with severe obstructive physiology like asthma or COPD is almost a completely opposite strategy compared to the patient with severe metabolic acidosis. They both have problems with ventilation (removal of carbon dioxide), ...
The 1stannual Rebellion in EM Clinical Conference took place in San Antonio, TX on May 11th– 13th, 2018. If you missed out in 2018, the Rebellion is coming back June 28th – 30th, 2019. Stay up to date as we plan ...
Before I set up the ventilator, I consider if my patient has one of the following 3 physiologic processes: severe metabolic acidosis, an obstructive process (Asthma or COPD), or refractory hypoxemia. If my patient doesn’t fit into one of these ...
Background: As with all medications in cardiac arrest (i.e. epinephrine, amiodarone) the benefits of sodium bicarbonate administration have been discussed and debated for decades. While it is clear that sodium bicarbonate can play a role in resuscitation of arrest due to ...
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