How Safe is Mechanical CPR?

Question – How safe is mechanical CPR compared to manual CPR? There are two devices used for mechanical CPR – the AutoPulse and LUCAS – neither of which has been demonstrated to show a survival benefit over manual CPR in r…

Novel Uses of Ultrasound in Cardiac Arrest

Question – How can you use ultrasound to figure out the etiology of a cardiac arrest? Much of the buzz surrounding ultrasound in cardiac arrest revolves around the intra-arrest echo and TEE. You can also use ultrasound to get some inf…

The Echo in ACS

Case – 70 year old male mhx of HTN, IDDM presents with 2 hours of exertional chest pain. His ECG in triage is unremarkable for any ischemic changes. He appears uncomfortable and over the next 30 minutes requires escalating doses of ni…

High Flow

Clinical Question – Why use High Flow Nasal Cannula? When should you use it over BIPAP? HFNC offers several advantages compared to conventional oxygen therapy, including: Ability to deliver O2 at up to 60 LPMs at nearly 100% FiO2. Thi…

A Young Man Presents with Syncope

Case – 26M with no medical history presents with chest pain and palpitations. He states that he passed out while walking. He denies associated symptoms or family history of sudden cardiac death. ECG: Question – What are the ECG…

Improving Your Echo Game

Clinical Question – What’s a systematic approach you can use to improve your Echo? Case – 66 M with IDDM, HTN, and obesity presents to Resus in septic shock. He is intubated for hypoxemic respiratory failure, and remains p…

LET – not just for lacs

LET gel, a combination of 4% lidocaine, 0.1% (1:1000) epinephrine, and 0.5% tetracaine in a methylcellulose gel, is commonly used as a topical anesthetic for the repair of skin lacerations, especially in children. It often eliminates the ne…

Pigtail Catheters for Pneumothorax

A patient presents 3 days after a lung biopsy with shortness of breath and chest pain. He has a normal HR and BP but SpO2 is 92% on non-rebreather at 15lpm. On bedside ultrasound, he has absent lung sliding on the right, and CXR confirms a…

When to give activated charcoal

A patient presents 30 minutes after intentional ingestion of 25 tabs of alprazolam. He is awake and talking, with normal vitals. This is a perfect situation in which to give activated charcoal, something that seems to be often discussed but…

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