Ultrasound G.E.L. – POCUS Rounds in the ICU
Does routine use of US during morning rounds on all patients improve patient outcomes?
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critical care
EM@3AM: Mucormycosis
A 65-year-old male with poorly controlled type 2 diabetes and ESRD on dialysis presents for right sided nose/facial discomfort and swelling and fever. Exam reveals altered mental status. He has right nasal swelling and tenderness, with a necrotic area on nasal septum. He is tachycardic, but the CV, pulmonary, skin, and GI systems are otherwise normal. What’s the likely diagnosis?
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Normal Lactate, but a Sick Patient… Lactate is Not Everything
Historically we’ve equated lactate with sepsis, but what else can cause an elevated lactate? When it comes down to it, lactate is only a number. This post investigates the ins and outs of this laboratory marker.
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EM in 5: Shock
How do you define shock? What are the different types? This video and post from Anna Pickens provide key pearls.
R.E.B.E.L. EM – Critical Care Updates: Resuscitation Sequence Intubation – pH Kills (Part 3 of 3)
In part three of this series we will discuss some useful strategies at the bedside to help us not worsen pre-intubation/peri-intubation metabolic acidosis.
EM Cases: Emergency Management of Intracerebral Hemorrhage – The Golden Hour
The skill with which you manage your patient with ICH in those first few hours could be the most important determinant of their outcome. In this Golden Hour you have a chance to prevent hematoma expansion, stabilize intracerebral perfusion and give your patient the best chance of survival with neurologic recovery.
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An Evidence-Based Approach to Pressors in Shock: Part II
Welcome back to Part II of the series on vasopressors. Part I discussed basic guidelines for pressor use, in addition to specific literature regarding “inopressors” (norepinephrine, epinephrine, and dobutamine). Part II will discuss “pure inotropes” (dobutamine and milrinone) and “pure vasopressors” (vasopressin and phenylephrine).
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R.E.B.E.L. EM – Fluid Responsiveness and the Six Guiding Principles of Fluid Resuscitation
From EGDT to PROCESS/ARISE/PROMISE to Surviving Sepsis Guidelines, we have seen a shift in how fluid resuscitation is monitored, but the idea of aggressive fluid resuscitation is still the crux of our hemodynamic management of these patients.
Thiamine Deficiency: Pearls and Pitfalls
Learn the nuances and importance of thiamine in your patient that presents to the ED. This in-depth article dives into the latest literature out on thiamine and how it relates to your patient in the ED.
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Healthy Patients with Potential to Crash
Well appearing patients who present to the emergency department (ED) rarely have serious disease. However, there are some conditions that can cause otherwise healthy patients to rapidly deteriorate. This article reviews a few conditions that can affect otherwise healthy patients and how to diagnose and treat these patients in the ED.
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