Does your choice of fluids for resuscitation in sepsis matter? Multiple studies have been performed to determine whether septic patients benefit from colloid versus crystalloid IV fluids, and other studies have specifically looked at the different kinds of fluids within those specific groups. Debate now exists as to which fluid will improve patient outcomes.
Fluid Choice in Sepsis: Does it matter? Read More »
A great deal of literature exists on sepsis and providing state of the art care in the ED. As EM physicians, we pride ourselves on resuscitating sick patients, and we are well aware that septic patients can rapidly decline clinically. Finding the source and providing appropriate antibiotics, adequate preload with IV fluids, and vasopressors if necessary are key components. The SIRS criteria are our first line of defense in the early identification of sepsis. But, it is important to recognize that just because a patient has multiple SIRS criteria, they may not actually be septic.
Mimics of Sepsis: What do ED Physicians Need to Know? Read More »
Are there any tests that can help you with Giant Cell Arteritis?
Can Giant Cell Arteritis Be Ruled Out in the ED? Read More »
The hot, altered, and stiff patient. What do you need to consider?
Serotonin Syndrome and Neuroleptic Malignant Syndrome: Pearls & Pitfalls Read More »
A power review of the literature on management of blunt and penetrating abdominal trauma
Abdominal Trauma: Is There Anything We Can Be Doing Better? Read More »
Continuous quantitative waveform capnography, also known as end-tidal carbon dioxide, PetCO2, or ETCO2, is a measurement of the partial pressure of CO2 in the exhaled breath. This technology has been around since the mid-19th century and only relatively recently has its potential in emergency medicine begun to be explored. […]
Capnography in the ED Read More »
Sepsis is the most common cause of death in children worldwide. What is the optimal evaluation and management of pediatric sepsis?
Pediatric Sepsis Update Read More »
Included below is a summary of numerous blog posts and podcasts that discuss the sometimes controversial issue of permissive hypotension or minimum volume resuscitation in the bleeding trauma patient.
Disclaimer: These are highlights as interpreted by the author of this article and should not replace listening to the original podcast or reviewing the background research. Posts are in chronological order and many of the below podcasts go beyond the scope of permissive hypotension. […]
A #FOAMed Roadmap to Permissive Hypotension Read More »
Does End Tidal CO2 correlate with PaCO2 in Traumatic Brain Injury?
Your neurosurgeons and trauma team have accepted a transfer to your hospital for intensive management of a trauma patient who presented to a small community hospital with a traumatic subarachnoid hemorrhage and epidural hematoma after being involved in a motorcycle accident.
Upon arrival with the critical care transport team, the patient is already intubated and stable on a a ventilator with appropriate sedation and stable hemodynamics. However, the neurosurgeons are in the operating room managing a spontaneous intraparenchymal hemorrhage and there are no available ICU beds due to multiple gun shot victims from a gang fight that you finished admitting.
While the patient is in the ED, the neurosurgeons recommend maintaining eucapnea for the patient since while there are no acute signs of herniation.(1)
Can you use the end tidal CO2(etCO2) or do you need to rely on arterial blood gas (ABG) measurements to maintain PaCO2 between 35-40 mm Hg? […]
End Tidal CO2 in TBI Read More »
A practice update on adult epiglottitis in the ED.
Adult Epiglottitis Update Read More »