Category Archives: Critical Care

Erasing Death

By Sabrina Schmitz, MD “Erasing Death” Explores the Science of Resuscitation (NPR—Feb 20, 2013) SUMMARY:   This is an NPR interview of Dr. Sam Parnia, Director of Resuscitation Medicine at Stony Brook, in which he discusses ideas presented in his … Continue reading

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Post Cardiac Arrest Syndrome: a review of therapeutic strategies

Stub D, Bernard S, Duffy SJ, Kaye DM. Circulation. 2011 Apr 5; 123(13):1428-35   By Felipe Teran, MD   Article capsule The significant morbidity and mortality associated with patients who survive to an Out-of-Hospital Cardiac Arrest (OHCA) has driven the … Continue reading

Posted in 1Intermediate, Cardiology, Critical Care, Hypothermia, Resuscitation | Leave a comment

Increased ICP and Herniation

By Tatiana Havryliuk, MD Please refer to EMCrit Ocular nerve sheath ultrasound – tegaderm, linear probe, 3mm down, then measure across – width  of optic nerve sheath is directly proportional to ICP – if <5mm then no ICP, if >6mm … 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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Mind of a Resuscitationist: STOP POINTS!

By Amy Sanghvi, MD Please refer to EMCRIT Your patient is in shock with a low MAP and on 2 pressors, or you about to start a second pressor agent, have second pressor STOP POINTS: Think for a second! Septic … 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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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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Sepsis: A review of the current therapy

By Christie Lech, MD Sepsis: A review of current therapy Please refer to EMRAP SIRS – your body’s response to various insults temperature > 38 or < 36 tachycardia, HR > 90 RR (> 20) or PaCO2 (< 32 mmHg) … Continue reading

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Increased ICP aka Brain Code

By Amy Sanghvi, MD Please refer to EMCrit Podcast # 78 In this podcast, Dr. Weingart discusses the care of patients with increased intracranial pressure and herniation in a Tier system. Use Bedside ocular nerve US to screen for inc … Continue reading

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Dominating the Vent

By George Lim, MD EMCrit: Dominating the Vent In the ED when you see patients about to be placed on vents, just think: Obstruction (ie asthma, COPD) vs Lung injury (ie. everyone else)? -       Simplifying vent parameters Tidal volume (Vt) … Continue reading

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