Monthly Archives: May 2012

OHSU: Ketamine vs Propofol

By Eduardo Lacalle, MD Ketamine vs Propofol [and ketofol, too!] 3 studies looking at ketamine, propofol, and the combination of the two (“ketofol”) for procedural sedation [sorry I don’t have the full titles – too difficult to get from … Continue reading

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OHSU/Oregon Poison Center Journal Club: ECGs in TCAs – September 2008

By Eduardo Lacalle, MD Toxicologists in the 1980s developed EKG criteria in TCA overdose as a quicker substitute for measuring serum TCA levels (which at time took hours, now takes days as a send-out). Originally the EKG finding to … Continue reading

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EMRAP: Shortness of Breath: Anaphylaxis, CHF, and Asthma

By Christie Lech, MD ANAPHYLAXIS Causes of shortness of breath: cardiac, pulmonary, “in your head”/anxiety, metabolic acidosis, neuromuscular, flail chest, “abnormal blood” – anemia, hypoxia, carbon monoxide exposure Causes of wheezing Reactive airway disease: COPD, asthma, bronchiolitis Heart failure … Continue reading

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EMRAP – SVT and Troponins

By Christie Lech, MD   Rapid, narrow, regular tachycardia A fairly benign arrhythmia If there are no other concerning symptoms – chest pressure, shortness of breath, diaphoresis – give the patient a good IV line, assess for a cause of … Continue reading

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EMCRIT #72 – Hemodynamically Unstable Pelvic Trauma

By Christie Lech, MD Check the iliac crest and push in, if you don’t feel movement, then you know there isn’t an open book pelvic trauma. If you feel the pelvis move inward under your hand, push harder until … Continue reading

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ERCAST – Cardiac Arrest

By Christie Lech, MD End tidal CO2: The best monitor you can have on a patient during cardiac arrest It is a monitor of 1) ventilation and 2) cardiac output, as a patient gets sicker, ETCO2 becomes more representative … Continue reading

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EMCRIT #71– Massive Transfusion

By Christie Lech, MD Criteria to initiate massive transfusion protocol: no good studies – Inaba reports that when a patient requires a threshold of 6 units of blood, massive transfusion protocol is initiated. There are studies that show that … Continue reading

Posted in 1Intermediate, Critical Care, EMCRIT, Trauma | Leave a comment