Monthly Archives: January 2012

Chest Pain in Pregnancy

By Christie Lech, MD EMRAP, December 2010  D-dimer – it doesn’t rise too much in the first trimester, and you can use the regular cut-offs.  About 60% of women with a healthy pregnancy with have elevated D-dimer concentrations.  Go from … Continue reading

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EMCrit #9 – Can you take sick patients to CT?

Sick patients in CT By Seth Trueger MD Is radiology still a dark place to go to die? Why should patients languish in the ED instead of getting their important studies? Here’s what you need in order to safely take … Continue reading

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EMCrit Podcast 63: Pain in the neck

EMCrit Podcast 63:   Pain in the neck   By Kei Ko, MD Nexus* C spine radiography unless: 1. No posterior midline cervical-spine tenderness 2. No evidence of intoxication a. No smell, observation, or suspicion of intoxication 3. Normal level … Continue reading

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EMCRIT 20 The Crashing Atrial Fibrillation Patient

EMCRIT 20 The Crashing Atrial Fibrillation Patient by Benjamin Schnapp Unstable rapid a fib – ACLS says shock the patient.  Dr. Weingart says, yeah try it once, but it probably won’t work. Optimize your chance of success – max joules … Continue reading

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EMCRIT 29: Procedural Sedation

CALL IT PROCEDURAL SEDATION – NOT CONSCIOUS SEDATION By Vishal Demla, MD Degrees of Sedation Minimal sedation – giving pain medication Moderate Sedation: Awake, alert, talking, the patient just has the edge taken off Deep Sedation – Patient reacts purposefully … Continue reading

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EMCRIT 32: Treatment of Severe Hyperkalemia

By Neil Singh, MD What potassium level should cause concern? A potassium level greater than 6 is concerning. Before beginning treatment, confirm that the specimen was not hemolyzed by talking to the nurse or checking with the lab. Now that … Continue reading

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Amal Mattu’s 2011 Cardiology Literature Update

By Vincent Roddy, MD Cardiac Arrest: -        “ABC” changed to -> “CAB” in cardiac arrest; Compressions, ie -> circulation most important in resuscitation of cardiac arrest patient -        PPV bad for patients à increased intra-thoracic pressure -> decreases venous return … Continue reading

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GOLDFRANK on DTs

by Christie Lech, MD EtOH withdrawal – Goldfrank  Benzos/barbs not completely effective in preventing withdrawal, but they can provide sedation As the alcohol concentration in your body falls, you may get seizures and a transient phase of alcoholic hallucinosis (this … Continue reading

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EMCRIT 12 : Trauma Resus

by Christie Lech, MD Trauma Resus MAP 65 Patients should be resuscitated to a MAP of 65 as the goal with signs of good tissue perfusion (i.e. good radial pulse, warm feet and hands) if MAP is greater than 65, … Continue reading

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EMCRIT 3: Intubating the patient with Severe Metabolic Acidosis

EMCRIT 3: Intubating the patient with Severe Metabolic Acidosis Courtesy of Christie Lech -     Should you give sodium bicarb? Won’t help that much, it works by taking hydrogen and metabolizing it to CO2; it can help in that some of … Continue reading

Posted in 1Advanced, 1Intermediate, Airway, Critical Care, EMCRIT, Non-Invasive Ventilation, Resuscitation | Leave a comment