Let’s talk about large bore/central vascular access! We’ll review different kinds, their different names, and when to use them!Of note outside the scope of this review: how to insert each of these – I think this is better learned by watchin…
Critical Care
Sickle cell disease affects ~ 100,000 people in the US. Though pain is the most common ED presentation for patients with SCD, we should always consider life-threatening emergencies in this devastating and complicated disease. Acute Chest S…
Central Line Week TR Pearl Series (all three pearls combined for this post) by Ryan LeBuhn, PGY-3 Informed Consent I once described the risks of a procedure so thoroughly that the patient no longer wanted the procedure, though avoiding the…
By Lara Silverman, MD/MPH Emergency Medicine PGY3 Pressors are used in hypotension. Per Scott Weingart, there are three main reasons we use pressors: Maintain critical perfusion pressors, especially to the brain, heart, and kidneys. B…
By Lara Silverman MD/MPH, Emergency Medicine PGY3October 2, 2022 Intro: Turns out most things in medicine are about acid-base disorders. A vent, understanding sepsis, kidney failure, respiratory failure, toxicology: so much of diagnosis and…
CSF shunts – these are the most common pediatric neurosurgery procedure done in the United States. While very common, these also have the highest rate of neurosurgical complications. About 50% fail within the first year, and the median survival of a shunt is usually 8-10 years, so a patient can expect 2-3 shunt revisions over the course of 20 years.
Today’s pearl: SEDATION DRIPS Titrating the sedation regimen on the sickest of patients can be one of the most challenging parts of the MICU. Anecdotally, many COVID+ vented patients in particular need at least 2, sometimes 3 diff…
For those who could not make it to VMR, we went over a truly sick calcium channel blocker overdose case. If not, here’s a quick rundown, and a link to the slides. Briefly, the case was a 17-year-old female who reportedly overdosed on 60 m…
We’ve all seen that movie where some old person coughs into a handkerchief and as the camera slowly pans away, there’s some blood stain. You know that guy isn’t making it to the end of the movie… Today, let’s t…
In addition to his love of ketamine and proper PSA technique, Reuben Strayer has written and talked extensively about ED intubations. Here is his checklist so that you can minimize complications and maximize your success: For more informati…
Courtesy of our Resus nurse extraordinaire Molly Sullivan! Here are some of the specifics about setting up an A-line at Sinai:
An Ode to Bougie Written by Paul Johnston So what’s a bougie? If you already know, skip this paragraph. A bougie is a flexible rod used to aid intubations. During a “conventional” intubation an ET tube w…
But what is the pH? Written by Erena Weathers Per direct request: “Some people can just look at a VBG and know what’s going on. I want to be able to do that!” First, big ups to Dr. Hashem Zikry of “Runs Really Fast…
Septic Shock and you want me to give Esmolol? Written by Erena Weathers Today’s pearl is a fun one, and one it seems not many have heard about. It is the idea in septic shock you can give esmolol to improve mortality. “But…
Before placementof your Sengstaken-Blakemore tube, your patient should be intubated to prevent aspiration. As this is only a temporizing measure, other services (GI, ICU, Maybe IR) should be notified and start mobilizing for definitive mana…
