Critical Care, ED and Emergency Department

Push-Dose Pressors in the Emergency Department

ACEP Now

JUNE 29, 2025

Welcome to Critical Care Time, a new critical care-focused column from ACEP Now. My goal in this column is to share tips, tricks, and emerging concepts from the intensive care unit (ICU) that you can use on your next shift in the emergency department (ED). This column is for you!

Emergency Department

Emergency Department E-9-1-1 Epinephrine Critical Care

US Probe: Velocity Time Integral (VTI) in Sepsis Management

EMDocs

JULY 9, 2025

In emergency departments, determining a septic patient’s fluid responsiveness can be challenging, as both under- and over-resuscitation can lead to poor outcomes. It is an essential metric for estimating cardiac output without the need for invasive procedures within the emergency department. F, and SpO₂ 92% on room air.

Emergency Department

Emergency Department ALS ICU Critical Care

Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

ACEP Now

JANUARY 5, 2025

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. Managing post-tonsillectomy hemorrhage in the ED can be challenging, especially in rural or resource-limited settings. Clin Pract Cases Emerg Med. Hemoptysis ED approach and management.

Operating Room

Operating Room Epinephrine ALS ED

EMCrit 404 – Facial Trauma

EMCrit Project

JULY 19, 2025

0000000000004651] Bellal Joseph, MD FACS Dr. Bellal Joseph is the Martin Gluck Endowed Professor of Surgery, Professor of Neurosurgery, Chief of General Surgery and Chief Division of Trauma, Critical Care, Burns & Emergency Surgery, at the University of Arizona. Questions Before Joining (FAQ) Join Now!

Critical Care

Critical Care ED Emergency Department OR

These are the ‘Roids you are looking for – Steroids in the ED

EMOttawa

JANUARY 9, 2025

From adrenal crises to septic shock, severe community-acquired pneumonia, and even acute pharyngitis, steroids play a pivotal role in managing a variety of conditions encountered in the Emergency Department (ED).

ED

ED Emergency Department Critical Care

All you need to know about Adrenaline

Don't Forget the Bubbles

JULY 7, 2025

You are working in the paediatric emergency department overnight, and the resus nurses are checking the emergency drugs during their daily checks. The department is quiet, and one of the newly qualified nurses asks you to explain why there are so many different concentrations of adrenaline and how they work.

Emergency Department

Emergency Department Epinephrine BLS ED

The SWAST Feedback Project

Don't Forget the Bubbles

JUNE 10, 2025

A recent study highlighted the gap in confidence surrounding paediatric assessment and management, and recommended a combined approach of targeted training and follow-up feedback from emergency departments after handover. Personalised feedback, in particular, is a powerful tool for clinical learning and reflective practice [2,3].

E-9-1-1

E-9-1-1 Emergency Department Paramedic Ambulance

EMCrit 1:1 Nursing 001 – An Easy Case of Sepsis

EMCrit Project

MAY 15, 2025

One thing to toss around that ends up effecting fluid resus in our ED – I see lots of providers ordering NS because Ceftriaxone – frequently used – isn’t compatible with LR. Questions Before Joining (FAQ) Join Now! Future Show: Upping your IV Game Fluids Get dinged for 4, rectal temps on elderly, etc.

ACS

ACS Critical Care Emergency Department ED

emDOCs Podcast – Episode 124: Non-Convulsive Status Epilepticus

EMDocs

AUGUST 11, 2025

ED Evaluation: Focus is assessing for other life-threatening treatable conditions: glucose, electrolytes, ECG. Imaging with CT in the ED; MRI while admitted. This is not possible in many EDs. Emergent EEG in the emergency department in patients with altered mental states. Int J Emerg Med.

ICU

ICU ALS Emergency Department ED

Emergency Care for All People in All Countries

ACEP Now

APRIL 8, 2025

An Events Taskforce conducts Around the World themed virtual learning series that have included topics such as trauma care, mental health emergencies, diagnostic dilemmas, simulation, and women in emergency medicine. Are you worried about the boarding crisis in emergency departments in the United States?

Emergency Medical Services

Emergency Medical Services Critical Care Emergency Department ED

Is Pip-Tazo Harming Sepsis Patients?

REBEL EM

NOVEMBER 11, 2024

found no difference in mortality in critical care patients treated with vancomycin and piperacillin- tazobactam compared to vancomycin and cefepime or meropenem. What They Did: Investigators performed a retrospective cohort study in the Emergency Department at the University of Michigan between July 1, 2014 through December 31, 2018.

E-9-1-1

E-9-1-1 ICU ALS Critical Care

The Kids THRIVE study: high-flow apnoeic oxygenation for intubation

Don't Forget the Bubbles

MARCH 21, 2025

A total of eleven intensive care units (ten PICUs and one non-maternity NICU) and four emergency departments (EDs) took part in the study. Given the emergency setting, the trial used a research without prior consent model, with delayed consent-to-continue obtained from the childs legal guardian as soon as practical.

ICU

ICU ED Critical Care OR

ICARUS ED Trial: Concentrated Albumin for Undifferentiated Sepsis in the Emergency Department

REBEL EM

AUGUST 11, 2025

🏥 Another ICU Myth Debunked in the ED: ICARUS joins SAFE & ALBIOS in showing no mortality benefit for albumin in sepsis—even when given early in the ED. 🤕 Case A 74-year-old man with a history of hypertension and chronic kidney disease is brought to the ED from home by EMS. Ann Emerg Med.

Emergency Department

Emergency Department ED ICU ALS

Smarter Medicine, Smarter Tools: Preparing EMS for the Next Era of Patient Care

JEMS

JUNE 12, 2025

MAML, NRP, WP-C 12 min read Share To: The annual ranking of the top-selling prescription drugs in the United States provides a window into the nation’s health, revealing trends in chronic disease and the rapid rise of breakthrough therapies steering patient care. Adapted from J. 2010 , 87 , 1348. & Cash, R. JACEP Open , 4(4), e13017.

E-9-1-1

E-9-1-1 EMS Mobile Integrated Health Community Paramedicine

Scripps Mercy Hospital San Diego’s Unique ED Culture Breeds Innovation

ACEP Now

JULY 3, 2025

The emergency department (ED) at Scripps Mercy Hospital San Diego is a different breed of ED. Seeing more than 76,000 annual visits, this urban academic Level I Trauma Center is a STEMI-receiving hospital, geriatric emergency department (GED) certified, and a Stroke Center. Click to enlarge.

ED

ED Emergency Department Naloxone Critical Care

Using Extracorporeal Membrane Oxygenation as Life-Sustaining Therapy

ACEP Now

JUNE 30, 2025

2 In the emergency department (ED), ECMO has emerged as an adjunct in the resuscitation of patients from acute cardiopulmonary failure. Chao is a clinical instructor of emergency medicine and health care ethics fellow at Michigan Medicine in Ann Arbor, Mich. References Allen NG, Jesus J, Knowles H, et al.

Life Support

Life Support CPR ALS Critical Care

First10EM Journal Club: November 2024

Broome Docs

NOVEMBER 17, 2024

PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study. Lancet Child Adolesc Health. 2024 Jul;8(7):482-490. doi: 10.1016/S2352-4642(24)00104-4. Epub 2024 Jun 4.

Epinephrine

Epinephrine Emergency Department Critical Care ICU

NeuroEMCrit – Neurocritical Care Year in Review 2023-2024 Part 1 – Acute Ischemic Stroke

EMCrit Project

JULY 23, 2025

Subscribe to our email list to keep informed on all of the Resuscitation and Critical Care goodness. Home EMCrit PulmCrit IBCC 1:1 ODR About About EMCrit PulmCrit – The Full Story EMCrit FAQ Subscribe to the Newsletter Contact Join Why Should I Become a Member? Questions Before Joining (FAQ) Join Now! We never spam; we hate spammers!

Critical Care

Critical Care Emergency Department OR ED

SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis

The Skeptics' Guide to EM

FEBRUARY 22, 2025

Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Vice Chair of Critical Care Medicine at Mayo Clinic Arizona. He is board-certified in Emergency Medicine, Medical Toxicology, Addiction Medicine, Internal Medicine-Critical Care, and Neurocritical Care.

Critical Care

Critical Care ICU ALS ED

Research Returns Spotlight to Physician ED Coverage

ACEP Now

APRIL 30, 2025

Research in JACEP Open , ACEPs peer-reviewed open access journal, features a map of the United States to show which emergency departments have round-the-clock coverage by a board-certified emergency physician. Nothing is shocking at first glance, said emergency physician and research co-author Deborah Fletcher, MD, FACEP.

ED

ED Emergency Department EMS OR

August 2025 News from the College

ACEP Now

AUGUST 4, 2025

If finalized as written, the proposed changes include notable wins for emergency physicians: the first Medicare payment increase for emergency physicians in six years, permanent codes for emergency medicine and critical care telehealth services, and; a new, more sophisticated, quality measure to tackle the boarding crisis.

Emergency Department

Emergency Department Critical Care OR ED

Which patient needs a CT scan?

Dr. Smith's ECG Blog

DECEMBER 16, 2024

She had this ECG recorded: Obvious massive anterior STEMI She was quickly brought to the critical care area and the cath lab was activated. The blood pressure was 170/100 in the critical care area. She has no SOB and no prior medical history. Her initial BP was 203/124. Case 2 A 50-something y.o. Vital signs were normal.

STEMI

STEMI Coronary Critical Care ED

Navigating Twists, Turns and Tears: BCVI in the ED (Part 2)

EMOttawa

JUNE 19, 2025

Blunt cerebrovascular injury (BCVI) involves vessel injuries that occur from trauma mechanisms commonly seen in the emergency department: falls down stairs, motor vehicle collisions, and facial trauma. By identifying high-risk patients early, we can decrease the risk of stroke by up to 15% with the use of aspirin.

ED

ED Emergency Department Critical Care

emDOCs Podcast – Episode 116: Massive Hemoptysis

EMDocs

MARCH 18, 2025

Airway: Key decision: base decision for intubation on clinical course, efficacy of airway clearance (coughing, mental status), ED/institutional resources, respiratory status (respiratory failure). Consult pulmonology/critical care, interventional radiology, and cardiothoracic surgery, which may mean transfer. Am J Emerg Med.

E-9-1-1

E-9-1-1 FFP ALS Critical Care

IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

REBEL EM

FEBRUARY 24, 2025

The use of point-of-care ultrasonography (POCUS) to evaluate the IVC as a marker for fluid responsiveness has spread from cardiology and nephrology into critical care and emergency medicine, transforming medical practice. RESUS SCENARIO Picture this: you just arrived at your shift at the local emergency department.

ALS

ALS E-9-1-1 Critical Care OR

EMCrit 1:1 Nursing Podcast 002 – Post-Intubation Sedation (Pain, Agitation, & Delirium)

EMCrit Project

JUNE 16, 2025

Intubated patients in the ED should have soft, wrist restraints places without the need for arduous, high-risk documentation or sitters Intubation Checklist EMCrit 176 – Updated EMCrit Rapid Sequence Intubation Checklist Awareness during Paralysis EMCrit 331 – Awareness after Resus RSI and ICU Paralysis – It is Unacceptable!!!

Critical Care

Critical Care ICU ED Emergency Department

EMCrit Guest Post – In Defense of Dignity by Chris Hicks, MD

EMCrit Project

JUNE 23, 2025

Episode 400 was a special one though, and buried in its dying minutes are Scotts four goals of resuscitation: Save lives / provide curative care Relieve suffering Enhance dignity Find connection Arguably in no particular order, and none are to the exclusion of the next. Questions Before Joining (FAQ) Join Now! Their cat.

Operating Room

Operating Room Critical Care Emergency Department OR

SGEM#415: Buckle Down for some Ultrasound to Diagnosis Distal Forearm Fractures

The Skeptics' Guide to EM

SEPTEMBER 9, 2023

New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care.

Critical Care

Critical Care ALS ED Emergency Department

Is there a Precedence for Precedex in the ED?

EMOttawa

OCTOBER 24, 2024

Precedex (dexmedetomidine) is an alpha-2 adrenergic agonist increasingly used in critical care environments for sedation and anxiolysis. It offers a unique profile of sedation without respiratory depression, making it an attractive option in various clinical scenarios. appeared first on EMOttawa Blog.

ED

ED ICU Critical Care Emergency Department

Podcast 185.0: Anticoagulation Reversal

Core EM

JANUARY 25, 2024

Hosts: Joe Offenbacher, MD Audrey Bree Tse, MD [link] Download Leave a Comment Tags: Anticoagulation , Critical Care , Resuscitation Show Notes Coagulation Cascade: Algorithm for Anticoagulated Bleeding Patient in the ED: Indications for Anticoagulation Reversal: References: Baugh CW, Levine M, Cornutt D, et al.

Frozen Plasma

Frozen Plasma FFP Plasma Critical Care

Episode 188: Vasopressors

Core EM

JANUARY 25, 2024

We go over the essential and complex topic of vasopressors in the ED.

Epinephrine

Epinephrine Critical Care ED Emergency Department

SGEM#414: The SQuID Protocol

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. ED visits /1000 adults with diabetes [1]. He is otherwise healthy.

ICU

ICU ED Critical Care ALS

SGEM#398: Another Ab Gets BUSED – POCUS in the ED for Biliary Disease

The Skeptics' Guide to EM

MARCH 25, 2023

Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and critical care.

ED

ED Critical Care Emergency Department ALS

SGEM#195: Some Like It Hot – ED Temperature and ICU Survival

The Skeptics' Guide to EM

NOVEMBER 18, 2017

Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Critical Care Medicine 2017. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia. Critical Care Medicine 2017.

ICU

ICU ED Emergency Department Critical Care

ALiEM AIR Series | Toxicology Module

ALiEM

FEBRUARY 5, 2024

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to toxicology in the Emergency Department. Ann Emerg Med. You will need to create a free, 1-time login account.

Overdose

Overdose Critical Care EMS Emergency Department

SGEM#283: Can You Be Absolutely Right in Diagnosing a SAH Using a Clinical Decision Instrument?

The Skeptics' Guide to EM

FEBRUARY 8, 2020

Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department. Stroke 2019 Guest Skeptic: Dr. Rory Spiegel is an EM/CC doctor who splits his time in the Emergency Department and Critical Care department.

Emergency Department

Emergency Department Critical Care ALS EMS

ALiEM AIR Series | Procedures Module

ALiEM

APRIL 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to related to procedures in the Emergency Department. More specifically, we identified 2 AIR and 4 Honorable Mentions.

EMS

EMS Emergency Department ED OR

Gen Z in the ED: Medical Student Perspectives on Emergency Medicine

Core EM

OCTOBER 16, 2024

Annie: I developed an interest in EM while working as a scribe in the ED during college. In addition to what Charlotte and Nick said, I can envision myself staying calm in the stressful situations that come up in the ED. How does your medical school support interest in emergency medicine careers?

ED

ED Critical Care EMS OR

Gen Z in the ED: Medical Student Perspectives on Emergency Medicine

Core EM

SEPTEMBER 24, 2024

Annie: I developed an interest in EM while working as a scribe in the ED during college. In addition to what Charlotte and Nick said, I can envision myself staying calm in the stressful situations that come up in the ED. How does your medical school support interest in emergency medicine careers?

ED

ED Critical Care EMS OR

ALiEM AIR Series | Respiratory 2023 Module

ALiEM

OCTOBER 14, 2023

After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to respiratory diseases in the Emergency Department. Ann Emerg Med. Reference Lin M, Phipps M, Chan TM, et al.

Critical Care

Critical Care Emergency Department EMS ALS

By the Hammer of Thora: Pleural Effusions in the ED (part 1)

EMOttawa

AUGUST 15, 2024

Assessing patients with pleural effusions in the emergency department (ED) can be challenging and unclear. This is largely due to the lack of guidelines around pleural effusions in the ED. In this post, I’ve tried to highlight some key information about an approach to patients presenting with a new pleural effusion.

ED

ED Emergency Department Critical Care

Impact of Emergency Department Crowding on Lung Protective Ventilation

REBEL EM

MARCH 27, 2023

2 Finally the settings initiated early in a patient’s care are often carried forward unchanged into their hospital and ICU stay. Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. J Crit Care. J Crit Care. Paper: Owyang CG, et al.

Emergency Department

Emergency Department ICU Critical Care EMR

SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest

The Skeptics' Guide to EM

FEBRUARY 25, 2023

Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric Critical Care Attending at Cincinnati Children’s Hospital Medical Center. Pediatric Crit Care Med. Background: We often manage patients in cardiac arrest in the ED or the intensive care unit (ICU).

CPR

CPR ICU Critical Care Defibrillator

SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC?

The Skeptics' Guide to EM

JANUARY 9, 2021

JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC? first appeared on The Skeptics Guide to Emergency Medicine.

EMS

EMS Emergency Medical Services CPR Critical Care

Push-Dose Pressors in the Emergency Department

US Probe: Velocity Time Integral (VTI) in Sepsis Management

Trending Sources

Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

EMCrit 404 – Facial Trauma

These are the ‘Roids you are looking for – Steroids in the ED

All you need to know about Adrenaline

The SWAST Feedback Project

EMCrit 1:1 Nursing 001 – An Easy Case of Sepsis

emDOCs Podcast – Episode 124: Non-Convulsive Status Epilepticus

Emergency Care for All People in All Countries

Is Pip-Tazo Harming Sepsis Patients?

The Kids THRIVE study: high-flow apnoeic oxygenation for intubation

ICARUS ED Trial: Concentrated Albumin for Undifferentiated Sepsis in the Emergency Department

Smarter Medicine, Smarter Tools: Preparing EMS for the Next Era of Patient Care

Scripps Mercy Hospital San Diego’s Unique ED Culture Breeds Innovation

Using Extracorporeal Membrane Oxygenation as Life-Sustaining Therapy

First10EM Journal Club: November 2024

NeuroEMCrit – Neurocritical Care Year in Review 2023-2024 Part 1 – Acute Ischemic Stroke

SGEM#468: Wide Open Monocytes – Using MDW to Diagnose Sepsis

Research Returns Spotlight to Physician ED Coverage

August 2025 News from the College

Which patient needs a CT scan?

Navigating Twists, Turns and Tears: BCVI in the ED (Part 2)

emDOCs Podcast – Episode 116: Massive Hemoptysis

IVC Distensibility Index vs Collapsibility Index: Using the Correct Index

EMCrit 1:1 Nursing Podcast 002 – Post-Intubation Sedation (Pain, Agitation, & Delirium)

EMCrit Guest Post – In Defense of Dignity by Chris Hicks, MD

SGEM#415: Buckle Down for some Ultrasound to Diagnosis Distal Forearm Fractures

Is there a Precedence for Precedex in the ED?

Podcast 185.0: Anticoagulation Reversal

Episode 188: Vasopressors

SGEM#414: The SQuID Protocol

SGEM#398: Another Ab Gets BUSED – POCUS in the ED for Biliary Disease

SGEM#195: Some Like It Hot – ED Temperature and ICU Survival

ALiEM AIR Series | Toxicology Module

SGEM#283: Can You Be Absolutely Right in Diagnosing a SAH Using a Clinical Decision Instrument?

ALiEM AIR Series | Procedures Module

Gen Z in the ED: Medical Student Perspectives on Emergency Medicine

Gen Z in the ED: Medical Student Perspectives on Emergency Medicine

ALiEM AIR Series | Respiratory 2023 Module

By the Hammer of Thora: Pleural Effusions in the ED (part 1)

Impact of Emergency Department Crowding on Lung Protective Ventilation

SGEM#394: Say Bye Bye Bicarb for Pediatric In-Hospital Cardiac Arrest

SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC?

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