“Ventilation is the profound secret of existence” – Peter Sloterdijk Article Citation: Brochard L, Mancebo J, Wysocki M, Lofaso F, et al. Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N En…
We do a lot of life-saving procedures and interventions on a daily basis in the emergency room. However, there are some much less frequent but equally as important life-saving procedures we need to know how to do. Today we will review how t…
What do all these EKGs have in common? They are all hyperkalemia! How hyperK+ are they? Turns out it is probably hard to say…there’s a Basic Rubric: P…
All the hard parts are done in the placement of your central line. You nicked the vein and NOT the artery. The wire threaded smoothly. You got confirmation on your ultrasound. Now, you just insert the triple lumen in over the wire. Insertin…
Intubating a patient with a suspected head bleed is one of the highest risk situations we encounter as ED physicians. A failed attempt with enough airway manipulation can potentially increase ICP and have profound negative effects on patien…
Arterial lines can provide accurate, real-time information on your patient’s blood pressure. They can be vital in cases where you want to trend precise blood pressure goals or where BP cuffs are producing incongruous measurements in…
The use of vasopressors and inotropes to treat hypotension is common in the emergency department. It is now standard to start off with norepinephrine as your 1st line agent to treat shock in the ED. But is norepi always that best choice?…
You have received a notification, EMS has a patient with “APE” or acute pulmonary edema. The patient arrives in respiratory distress and if you do nothing, she will require intubation. However, you are well practiced in the us…
You are working resus at 3 am when you hear an alarming vent. It’s the patient in room “E” who is intubated and has been admitted for 36 hours waiting for a stepdown bed. The patient is satting 99% and you are tempted to just hit the sile…
Ventilator management can be very simple or complex. As boarding continues to plague the emergency department, ventilated patients become more commonplace. The emergency physician should be well versed in ventilator settings as well as acti…
Last pearl before our inservice tomorrow. Good luck to everyone. Hopefully this will buy you an additional point. Jefferson Bit Off A Hangman’s Tit = Unstable cervical spine fractures Jefferson Fracture A burst fracture of the…
A 65 yo M is rushed into the resus room. He is pale and is vomiting a mixture of coffee ground emesis and bright red blood. His vitals are stable currently but he is continuing to vomit in the emergency department. This patient requires a d…
You are working resus at 2 am when EMS rolls in with a 60 year old patient with fever and cough, hypotensive to 83/40 with a HR of 142. This septic patient needs emergent fluid resuscitation. You notice the RN about to place a peripheral IV…
Resuscitate NYC 2016 was amazing. Special thanks to Scott Weingart (@emcrit) and Felipe Teran (@FTeranmd) who made it all possible! Get an inside look at how it all happened. Attendees: 540 EM Residents 50 Faculty from EM and CC 50 EMS, RN…
Status epilepticus is one of the few neurologic emergencies. Many protocols for persistent status involve dosing with a benzodiazepine, then another benzo, then an antiepileptic medication, and finally, continuous sedation with intubation….
