For our clinical pearl today I thought I thought I would do some basic ECG teaching. This is a real case that I saw with Carlo at Elmhurst in the cardiac room. As always, we will start with a clinical scenario. A middle-aged male with unkno…
Compiled from a variety of sources from #FOAMed (specifically, NYSORA and the ACCRAC podcast) and inspired by morning report today with Taryn and Tina, here is a quick and dirty rundown for awake intubation. Firstly, we should be considerin…
Inspired by a morning report discussion from our very own Lara Vanyo on preoxygenation strategies, I thought it would helpful for a brief run-down on the button-pushing needed to perform preoxygenation by way of noninvasive ventilation. The…
A number of really bright people are still unsure of what to make about the vitamin C, steroids and thiamine newsflash that’s taken Twitter by storm yesterday. At Sinai here we’re the curious types, so we chatted with our pharmacist who sim…
Does it matter if my patient getting tPA is on prestroke antiplatelets? The neurology and ED teams have decided to give tissue plasminogen activator (tPA). As an outpatient, the patient is on aspirin and clopidogrel dual antiplatelet…
The 52 in 52 Review: Comparison of Dopamine and Norepinephrine in the Treatment of Shock Article Citation: De Backer D, Biston P, Devriendt J, et al. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med….
Citation Fuller BM, Ferguson IT, Mohr NM, et al. Lung-Protective Ventilation Initiated in the Emergency Department (LOV-ED): A Quasi-Experimental, Before-After Trial. Ann Emerg Med. 2017; Clinical Question Does a multifaceted, 4-part, ED-ba…
Traumatic Brain Injury & Neurocritical Care You’ve just intubated your traumatic brain injury patient and the repeat pupil exam shows signs of herniation. In addition to your other interventions (e.g., Reverse Trendelenburg positioning,…
High-Flow Nasal Cannula for Avoiding Intubation? Citation: Ni YN, Luo J, Yu H, et al. Can high-flow nasal cannula reduce the rate of endotracheal intubation in adult patients with acute respiratory failure compared with conventional…
Article Citation: Jones AE, Shapiro NI, Trzeciak S, et al. Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial. JAMA. 2010;303(8):739-46. What We Already Know About the…
The Right Ventricle The right ventricle (RV) has been getting more coverage lately from the Wilcox et al review article in Annals to the continued coverage in many critical care circles where anesthesia and emergency medicine overlap.(1) F…
Post-intubation Sedation – Tips for the Intubated Patient You’ve just finished intubating your hypotensive, acute respiratory failure patient. Other than the pharmacologic and hemodynamic considerations, what other things should infor…
“Trust, but verify” -Ronald Reagan Why would you need ultrasound for tube confirmation? You can confirm placement with direct visualization (sometimes video laryngoscopy), use end tidal CO2, look for color change on color…
“The role of a clown and a physician are the same – it’s to elevate the possible and to relieve suffering.” -Patch Adams Do you regularly raise the head of the bed when you intubate? Well, maybe you should! A recen…
“There is nothing like the cure of fresh air for cases of bladder infection, paranoia, and Cartesian thinking.” -Rawi Hage Title: “The 52 in 52 Review: Noninvasive ventilation in acute cardiogenic pulmonary edema” Article Cita…
