Therapeutic Hypothermia (also called targeted temperature management (TTM)) is a deliberate reduction of the core body temperature to 32 - 34°C, in patients who suffer cardiac arrest with return of spontaneous circulation, but also don't regain consciousness. In REBEL Crit Cast episode 1, I will go through the evidence for cooling adults and children, potential adverse effects, and what temperature to shoot for.
Background: Traditionally, vasopressors have been given through central venous catheters (CVCs) in the critically ill.However, the time it takes to place a CVC is time a patient could potentially remain hypotensive. Early initiation of vasopressors may be associated with reduced mortality by increasing end-organ perfusion. Therefore, there has been a growing trend to use vasopressors through peripheral IVs (PIVs). Running pressors through a peripheral IV has a couple of important benefits including faster time to pressor initiation and no need for invasive procedures (i.e. CVC). There islittle evidence to support the safety of this practice other than one systematic review which included case reports and small case series. Now we have two more papers that evaluate this very question…are peripheral pressors safe?...Read More
REBEL EM-ers: Salim & I would like to introduce the launch of a new REBEL EM project. We are adding a podcast focused on a wide variety of resuscitation and critical care topics in both Adult & Pediatric Medicine to the website. The podcast will be called REBEL Crit Cast, and will compliment are already popular REBEL Crit content on our parent site. This will include blog posts and podcast content with a dedicated place on the parent site.
Instead of creating a separate podcast, we’ll be bringing you REBEL Crit Cast as part of REBEL Cast. This way, you won’t need to download another podcast.
The format may change over time, and I'd love to know your questions, and ideas for topics so that I can make this as practical and useful to YOU, our audience, as possible....Read More
Important as front line providers to know research and data behind stroke care
Patients eligible for endovascular care are those with large vessel occlusion in the anterior circulation - anterior cerebral artery, middle cerebral artery, distal intracranial carotid artery and they have to have perfusion mismatch (small infarcted core with a large penumbra).