Browsing: Critical Care

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Critical Care , Ventilator Management

Doubling Down on Re-Expansion Pulmonary Edema: Treatment Approach and Ventilator Management

10/16/2018 Mark Ramzy, DO, EMT-P
The treatment of choice for a pneumothorax is a chest tube, and when the small pig-tail catheter doesn’t do the job, the answer is to replace it with a larger bore – right? Not so fast.
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Critical Care , Critical Care Alert

Critical Care Alert: Hydrocortisone plus Fludrocortisone for Adults with Septic Shock (APROCCHSS)

9/10/2018 Sean M. Hickey, MD
Can the use of hydrocortisone plus fludrocortisone and/or drotrecogin alfa improve clinical outcomes in patients with septic shock?
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Critical Care

Massive Hemoptysis

8/18/2018 Utsha Khatri, MD , Brian Weiss, MD
Consensus is lacking on specific thresholds to characterize massive hemoptysis because these numbers can be challenging to reliably obtain and fail to predict the severity of disease.
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Critical Care , Critical Care Alert

Critical Care Alert: Balanced Crystalloids vs. Saline in Critically Ill Adults (the SMART Trial)

7/19/2018 Susannah Empson, MD
Could balanced crystalloids offer better outcomes than normal saline infusions? The SMART trial tracked mortality, new renal-replacement therapy, and persistent renal dysfunction among critically ill
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Critical Care

Trapped Tap: Considerations When Performing ED Thoracentesis

6/11/2018 John Joseph, MD , Mary R. Haas, MD , Ivan Co, MD
There are no hard and fast rules for therapeutic thoracentesis in the ED setting but there are some accepted best practices.
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Critical Care

The Use of the Angiocatheter in Central Line Insertion: The Advantage and the Technique

6/10/2018 Danielle T. Miller, MD
Two techniques are currently used for guidewire insertion during central venous catheterization: introducer needle and angiocatheter over an introducer needle. Is one technique better than the other?
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Critical Care

Hepatic Syndromes

6/10/2018 Joshua Glick, MD , Clinton J. Orloski, MD , Stephen Hallisey, MD
Hepatorenal and hepatopulmonary syndromes can be easy to diagnose in the ED, and proper management can significantly impact morbidity and mortality downstream.
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Critical Care

A "Super" Case of Spontaneous Pneumomediastinum

6/10/2018 Joshua Glick, MD , Brett Guido, MD
Repeated Valsalva maneuvers - like forcefully exuberant cheering - may not be the most common cause of Hamman's Syndrome, but it can happen.
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Critical Care , Critical Care Alert

Critical Care Alert: Endovascular Therapy Option for Late Presenting Ischemic Stroke Patients

5/10/2018 Meghan Gorski, DO , Yanika Wolfe, MD , Clark Owyang, MD
Ischemic stroke is one of the most common causes of death and devastating permanent disability worldwide. Two new trials - DAWN and DEFUSE 3 - suggest endovascular therapy could benefit patients prese
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Critical Care , Neurology , Traumatic Brain Injury , Trauma

Revisiting Cerebral Perfusion Pressure: A Framework for Approaching TBI

4/15/2018 Kristin Schmid, MD , Tina Chen, MD
In the United States, more than 2.5 million patients seek care for traumatic brain injury every year, accounting for approximately 2% of all ED visits. The equation for cerebral perfusion pressure can