The Sick MI Patient
The sick MI patient: What are the scary complications, and what can you do?
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resuscitation
Mimics of Sepsis: What do ED Physicians Need to Know?
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.
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I’ve got a pulse… now what? – Post-Arrest Care in the Acute Setting
“I’ve got a pulse,” you hear the nurse shout. Finally, a sigh of relief comes over the crowded resuscitation room and you take a moment to reflect on what just happened… but, your work is just now about to truly begin. It is up to you to determine why the patient died in the first place and determine which crucial steps need to be initiated to increase your patient’s chance of survival.
I’ve got a pulse… now what? – Post-Arrest Care in the Acute Setting Read More »
Hypothermia and Drowning Pearls
Winter is coming…well maybe not yet, but you never know when you will see your next drowning or hypothermic patient will enter your ED, so be prepared! Check out the latest pearls on hypothermia and drowning!
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EM Care of the Obese Patient: Pearls & Pitfalls
As the obesity epidemic continues to rise, we must be equipped to deal with the challenges that these patients bring to the emergency department. Dr. Mallemat discusses the pearls & pitfalls of the obese patient in EM, as well as some useful tips & tricks.
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Resuscitation of the Pregnant Trauma Patient – Pearls and Pitfalls
While on shift at a busy urban emergency department, you are notified by EMS dispatch of an ambulance en-route with a patient involved in a high-speed MVC. They report she is a female, in her 20s or 30s, who is obviously gravid, but of unknown gestational age. According to EMS vital signs are: HR 104, RR 25, BP 104/54, and SpO2 98% on room air. They are requesting activation of your trauma team.
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Fluid Resuscitation: Isotonic Saline vs Balanced Fluids
“Untoward patient-centered effects had not definitively been demonstrated until recently”
Nick Johnson, MD (@NickJohnsonMD) discusses the recent evidence comparing isotonic saline with balanced fluids for resuscitation of septic patients.
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Vaginal Bleeding in the Non-Pregnant Patient
Jason Kan, MD covers the various causes and ED management strategies for severe vaginal bleeding in non-pregnant patients.“PALM-COEIN separates the differential for vaginal bleeding into structural and non-structural causes”
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Massive Blood Transfusion
“There has been ongoing controversy regarding the ratio of components that should be given during massive transfusion”
How do you avoid inducing a coagulopathy in trauma patients requiring massive blood transfusion? Zach Radwine, MD summarizes the recent evidence for the 1:1:1 ratio.
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Bleeding in the Patient with Renal Failure
“Within the next decade, the incidence of CKD is expected to nearly double”
In this article, Matt Smetana, DO describes the common manifestations of hemorrhage in uremic patients, and then outlines strategies to stop the bleeding.
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