Category Archives: 1Intermediate

Transfusion Strategies in Acute Upper GI Bleed by Villanueva, et al.

Summarized By Kei Ko, MD Refer to NEJM January 3, 2013 Background Prospective randomized controlled trial comparing restrictive vs. liberal transfusion strategy. This study was performed since the authors stated no previous studies looked specifically at GI bleeds and transfusion … Continue reading

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Dangerous Pediatric Fevers

By Christie Lech, MD Refer to EMRAP Herpes Simplex Virus Infection Infection in neonates is usually HSV-2, but also can be HSV-1 and can present with fever, seizures, and possibly cutaneous manifestations (i.e. vesicles). The mortality is high, and there … Continue reading

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The Crashing Neonate

By Christie Lech, MD Refer to EMRAP Unbundle babies. Get a good blood pressure. Neonates will not present with meningismus with meningitis Get a line! Think IO. Or a scalp vein. Get the neonates weight. Hct are high when babies … Continue reading

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Pediatric UTI

By Kei Ko, MD Please refer to SMARTEM Part I Original date: Jan. 23, 2011 1993 – Practice guidelines published and it suggested <3 month age group, a full sepsis workup and <1 month admitted with iv abx, and 1-3 … Continue reading

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Matt and Mike’s Podcast on Hip Ultrasound

By Felipe Teran, MD Please refer to Ultrasound Podcast  In this episode Matt and Mike discuss the utility of US for: -       Diagnosis of hip effusion -       US guided hip aspiration -       US guided hip injection US guided hip aspiration … Continue reading

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A confirmation of prejudices: chloride and pressure poisoning

By Avital Porat, MD Please refer to EMCRIT We should be thinking more of our fluids and not just grab normal saline Normal saline is very acidic – as it has equal amounts of Cl and Na Balanced solutions: Na/Cl … Continue reading

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Ultrasound for Fluid Tolerance in Spontaneously Breathing Patients

By Christie Lech, MD Please refer to EMCRIT If you have a mechanically ventilated patient, and they are on 10 cc/kg of tidal volume for your IVC check.  If the IVC gets larger by 16-18%, the patient will be fluid … Continue reading

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LBBB and Sgarbossa Criteria

By Christie Lech, MD Please refer to EMRAP Current recommendations for acute reperfusion treatment: Patient presenting with chest pain or other concerning symptoms Patient with a STEMI on EKG, a STEMI equivalent i.e. posterior MI, new or presumed new LBBB, … Continue reading

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The Crashing Asthmatic

By Zara Mathews, MD Please refer to EMCRIT Podcast #16 What to do when an intubated asthmatic starts to crash? FIRST disconnect vent from ET tube breath stacking can stop venous return to heart  will hear gush of air from … Continue reading

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Post-Intubation Package

By Christie Lech, MD Emcrit: Post-Intubation Package Number 1, know the analgesia and sedation agents you want Secure the tube – the Hollister anchor device is recommended because it 1) doesn’t block the mouth and 2) does not cause pressure … Continue reading

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