Sepsis is a common disease, but sometimes, we need some assistance with the diagnosis and resuscitation of these patients. Can biomarkers help us, or are we wasting time using these measures? What’s wrong with just the time-honored history and exam?
Sepsis Biomarkers: What’s New? Read More »
The patient with acute valvular emergency can be terrifying. These patients may rapidly decompensate, and the physiology and management are complex. What can you do to prepare? This post provides pearls and pitfalls in the evaluation and management of patients with acute valvular emergency. You may be surprised what you read…
Acute Valvular Emergencies: Pearls and Pitfalls Read More »
Epinephrine is a key component of ACLS measures. But what does the data show? This post evaluates the ACLS recommendations for epinephrine in cardiac arrest, the literature behind its use, and future directions.
A Myth Revisited: Epinephrine for Cardiac Arrest Read More »
How do you care for the crashing trauma patient? This post takes you through the critical resuscitation step-by-step.
The Crashing Trauma Patient Read More »
Your overnight junior calls for your help with his decompensating intubated patient. The patient is a 54 year-old male with a history of COPD who was intubated ten minutes ago. The ventilator is alarming due to high pressures. The patient’s current vitals are HR 140, BP 80/50, SpO2 82%. The ventilator settings are VCV rate 12, tidal volume 450, PEEP 15, FiO2 100%. You quickly disconnect the circuit but the patient is not improving. What do you do next?
Taking Ownership of the Ventilator – How to Manage and Troubleshoot Read More »
The increased troponin used to be a straight ticket to the cardiology service. Now, the picture isn’t so clear. What do you need to consider in the patient with elevated troponin?
The Elevated Troponin: What else besides ACS could cause troponin elevation? Read More »
What do you do with the head trauma patient who is anticoagulated? Do you discharge the patient, observe and repeat CT, or admit the patient? This post evaluates this question and more.
The Anticoagulated Patient with Head Trauma: What’s the Disposition? Read More »
Hemolytic uremic syndrome is a potentially deadly disease, comprised of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and acute kidney injury (AKI). This post evaluates the pathophysiology, evaluation, and management of HUS.
Hemolytic Uremic Syndrome (HUS): Pearls and Pitfalls Read More »
Administering a thrombolytic in a cardiac arrest from MI remains controversial. Data remains limited and should be considered on a case by case basis.
In 2002, a new standard of care was established when the Surviving Sepsis Campaign (SSC) highlighted the importance of recognizing sepsis and initiating treatment early. Once we find that a patient meets Systemic Inflammatory Response Syndrome (SIRS) criteria with a source of infection, rapid and appropriate treatment including resuscitation is a must. Early fluid resuscitation is necessary for septic patients, but there is large variance on the aggressiveness of fluid resuscitation. There is disagreement amongst the experts on the total amount of fluids that should be administered and the end points for resuscitation. We must ask ourselves, at what point does our aggressive resuscitation actually start to harm our patients?
Resuscitation in Sepsis: How Much is Too Much? Read More »
