Category Archives: EMCRIT

Critical Care Palliation with Ashley Shreves

By Gene Schiappa, MD Please refer to EMCrit As terminal disease course progresses: Disease driven care: decrease Palliative care : increase   Overall care required may increase. Patients and family require additional assistance and services.   3 areas of improvement … Continue reading

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Severe Accidental Hypothermia

By Taylor Moran-Gates, MD Please refer to EMCrit 1. >32c: -Treatment is simple: Passive rewarming, warm blankets. -Evaluate other causes: hypoglycemia, etoh, myxedema, Addison’s, sepsis. -Labs: cbc, chemistry, tfts, cortisol, cultures. -Bradycardia: sinus bradycardia is expected, and does not require … Continue reading

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Treatment of Aortic Dissection

By Paolo Hernandez, MD Please refer to EMCrit Most import thing is to lower dP/Dt, change in pressure seen by aorta over time, by decreasing heart rate, ionotropy and afterload.  This can be done by: -        Step 1:  Control pain!!! … Continue reading

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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

Posted in 1Advanced, Critical Care, EMCRIT, neuro | Leave a comment

Lessons from the STOP Sepsis Collaborative

By Avital Porat, MD Please refer to EMCrit Take home lessons after ~ 10,000 patients enrolled in STOP Sepsis Collaborative   Recognition/Screening- Let nurse’s handle this. They are doing a good job. Modified version of SIRS criteria screened at triage … Continue reading

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Oxygen Physiology with Daniel Davis

By Avital Porat, MD Please refer to EMCrit Daniel Davis from UCSD with extensive work in resuscitation (specifically airway and oxygenation) Pulse Oximetry Lag (or latency) When a pulse ox probe is placed on a digit there is a predictable … Continue reading

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Severe Trauma with Karim Brohi

By George Lim, MD Please refer to EMCrit PERMISSIVE HYPOTENSION -       For Dr. Brohi, permissive hypotension is more of a mindset more so than goal BP’s If he had to give number, SBP < 60 or 70 then provide crystalloid/blood … 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

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