Emergency Medicine Ireland

DECEMBER 3, 2020

Welcome back to the tasty morsels of critical care podcast. As an EM trainee doing intensive care I will confess that I struggle to work up the enthusiasm to cover a nutrition guideline. Read More » Welcome back to the tasty morsels of critical care podcast. As with all ICU nutrition EN is preferred over PN.

Critical Care

Emergency Medicine Ireland

SEPTEMBER 20, 2021

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. After 2 years of frequent, if not daily use of the bronch, I find it hard to see how I would manage in an ICU without it. Why might we pull out the bronch in the ICU?

Critical Care

ALiEM

MAY 19, 2023

Esophageal Balloon Tamponade Devices – Linton-Nachlas, Sengstaken-Blakemore, Minnesota Tubes (image courtesy of Dr. Mark Ramzy at REBEL EM) What are esophageal balloon tamponade devices? It is time to MacGyver a method that allows you to know the esophageal balloon pressure that you are generating to avoid an esophageal rupture.

E-9-1-1

Emergency Medicine Ireland

JUNE 10, 2024

Welcome back to the tasty morsels of critical care podcast. I have previously covered this on the old tasty morsels of EM series back when i was doing my EM fellowship exams. The classic EM example is the whole family who present with flu symptoms and no fever and even the dog is sick. How does it make people sick?

Critical Care

Emergency Medicine Ireland

FEBRUARY 6, 2023

Welcome back to the tasty morsels of critical care podcast. Given that a lot of ICU bed days are given over to managing SAH, I felt it might have warranted its own chapter. Though i’ll admit that that question is delving much more into the realm of EM than hard core crit care.

Critical Care

Emergency Medicine Ireland

MAY 16, 2022

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. I am guilty of over teaching this myself having delivered not one , but 2 talks on the subject, and even a prior tasty morsel of EM on the subject. Today we’re looking at asthma.

Critical Care

Emergency Medicine Ireland

NOVEMBER 1, 2020

Welcome back to the tasty morsels of critical care podcast. DKA is bread and butter for critical care providers. Read More » Welcome back to the tasty morsels of critical care podcast. DKA is bread and butter for critical care providers.

Critical Care

Emergency Medicine Ireland

DECEMBER 24, 2020

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. References: Oh’s Manual Chapter 47 Tasty Morsels of EM 116 It covers Oh’s Manual Chapter 47 looking.

Critical Care

Emergency Medicine Ireland

JULY 5, 2021

Welcome back to the tasty morsels of critical care podcast. Read More » Welcome back to the tasty morsels of critical care podcast. Oh is quite pro IV infusions and certainly in the ICU and OT this is ubiquitous and generally well done in my experience. Today we look at anaphylaxis. Today we look at anaphylaxis.

Critical Care

AAEM RSA

JUNE 30, 2021

Pursuing an emergency medicine residency affords a fast-paced, often unpredictable environment with a diversity of patients unique to the specialty, while the life of an internist involves rounding, longitudinal patient care, and long contemplative sessions pertaining to pathophysiology and diagnosis. Martinez J.

EMS

REBEL EM

FEBRUARY 8, 2024

Accuracy of Noninvasive Blood Pressure Monitoring in Critically Ill Adults. J Intensive Care Med 2024. PMID: 38215002 Clinical Question: In critically ill adults in the ICU is noninvasive blood pressure (NIBP) monitoring similar (≤10% difference) to invasive arterial blood pressure (IABP) monitoring? to 1.12; p = 0.03

ICU

Emergency Medicine Ireland

OCTOBER 27, 2020

The knowledge contained will hopefully be sufficient to allow you to not look completely clueless on the ICU round when the topic of PR3+ve ANCA vasculitis comes up. As such this hopefully will occupy the niche of “exam prep/board review” in the already somewhat crowded critical care podcast scene.

Critical Care

EMDocs

NOVEMBER 1, 2023

Authors: Katey DG Osborne, MD (EM Attending Physician; Tacoma, WA), Rachel Bridwell, MD (EM Attending Physician; Tacoma, WA) // Reviewed by: Alex Koyfman, MD (@EMHighAK, EM Attending Physician, UTSW / Parkland Memorial Hospital) and Brit Long, MD (@long_brit, EM Attending Physician, San Antonio, TX) Welcome to emDOCs revamp!

Critical Care

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. The result of this ED capacity strain and less than ideal patient to staff ratios has led to delays in interventions, treatments and care adjustments. J Crit Care. Paper: Owyang CG, et al.

Emergency Department

Critical Care Scenarios

OCTOBER 31, 2021

Boswell (EM and CCM) of the University of Maryland, perhaps the busiest center in the country for COVID-related ECMO. Boswell (EM and CCM) of the University of Maryland, perhaps the busiest center in the country for COVID-related ECMO. An overview of VV ECMO with a focus on COVID-19, with Dr. Kimberly A. Data remains slim,

Interfacility Transport

REBEL EM

JUNE 8, 2023

The relationship between ICU hypotension and in-hospital mortality and morbidity in septic patients. Intensive Care Med. Rezaie, MD (Twitter: @srrezaie ) The post The Safety and Efficacy of Push Dose Vasopressors in Critically Ill Adults appeared first on REBEL EM - Emergency Medicine Blog. J Med Toxicol. Am J Emerg Med.

Epinephrine

Broome Docs

OCTOBER 31, 2022

Ketamine vs etomidate in ICU intubation ? PMID: 34904190 Not surprisingly, this paper has been covered by basically everyone who talks about research, so if you want to hear some other opinions, check out the SGEM , REBEL EM , or St. Anaesth Crit Care Pain Med. Tips for radial artery art lines Imbrìaco G, Monesi A, Spencer TR.

E-9-1-1

Don't Forget the Bubbles

AUGUST 28, 2023

You contact ICU, anaesthetics, ENT, and oncology with a plan to attempt more definitive imaging in the prone position (which Ginny tells you is much comfier) What’s the evidence for our emergent management? See their website for more: [link] References Carter BW, Marom EM, Detterbeck FC. A CXR demonstrates a mediastinal mass.

Emergency Management

ACEP Now

JULY 7, 2024

35-year-old man presents by EMS with seizures. He has been seizing for 30 minutes, despite treatment of intravenous lorazepam by EMS. 4 With the increasing utilization of EEG, especially continuous EEG, nonconvulsive seizures have been increasingly recognized and diagnosed as a cause of altered mental status in critically ill patients.

Emergency Department

REBEL EM

FEBRUARY 2, 2023

2 Amiodarone is commonly known for its anti-arrhythmic properties and a commonly used agent in the Intensive Care Unit (ICU). This could have biased the results in favor of amiodarone as we’ve covered this before on REBEL EM before The IV amiodarone group required less additional HR control agents to control increased heart rate.

Emergency Department

REBEL EM

SEPTEMBER 29, 2022

For More on This Topic Checkout: CorePendium: Pancreatic Disease Internet Book of Critical Care: Acute Pancreatitis EMCrit: Ep333 – The State of Fluids Show with the EMCrit Core Team The Bottom Line: Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis References: de-Madaria E et al. cc/kg/hour.

ICU

REBEL EM

MAY 8, 2023

appeared first on REBEL EM - Emergency Medicine Blog. 2,230 records remained after the elimination of duplicates. 2,210 records were excluded after screening.

E-9-1-1

EMDocs

JUNE 22, 2024

We’ll keep it short, while you keep that EM brain sharp. According to EMS, she was in labor at home and delivered the newborn shortly after they had loaded her into the ambulance. Treatment is supportive with respiratory therapy, critical care, inotropic therapy, and cardiac life support. link] j.ajog.2016.03.012

EMS

REBEL EM

OCTOBER 5, 2023

ClinicalTrials.gov: NCT02517489 7 Clinical Question: In adult patients with severe community-acquired pneumonia admitted to the ICU, does early hydrocortisone treatment, compared to standard therapy, reduce mortality at 28 days? Patients enrolled from 31 Intensive Care Units in France. ICU-acquired infections were observed in: 9.8%

Critical Care

The Skeptics' Guide to EM

OCTOBER 3, 2021

Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Consultant in the Department of Critical Care Medicine at Mayo Clinic Arizona. Case: A 66-year-old woman is brought in by EMS from home with lethargy and hypotension. Reference: Zampieri et al.

OR

Emergency Medicine Ireland

JANUARY 22, 2024

Welcome back to the tasty morsels of critical care podcast. Today we’ll cover some key exam content, all be it not something you’re likely to run into in the ICU too often. Your ICU probably has it and you’ve typically only seen it as part of management of a potential organ donor in brain death.

Critical Care

REBEL EM

FEBRUARY 29, 2024

3, 4 It is the most common nosocomial infection in patients on mechanical ventilation, and one of the leading causes of nosocomial infection among all patients in the ICU. The low incidence could be a result of the systematic implementation of bundles known to decrease VAP incidence in the ICU. 4, 8 Paper: Dahyot-Fizelier, C.,

E-9-1-1

The Skeptics' Guide to EM

JULY 16, 2022

Salim is also the creator and founder of REBEL EM and REBEL Cast, a free, critical appraisal blog and podcast that try to cut down knowledge translation gaps of research to bedside clinical practice. She is admitted to the intensive care unit (ICU) for septic shock. Reference: Lamontagne F et al.

ICU

REBEL EM

AUGUST 21, 2023

In response to this critical issue, the TAME Cardiac Arrest Trial has been launched as a definitive phase III multi-center randomized controlled trial for resuscitated cardiac arrest patients. Monitoring cerebral pressures is crucial in assessing the impact of interventions, especially in critical care scenarios.

E-9-1-1

Dr. Smith's ECG Blog

JUNE 23, 2024

His daughter immediately started CPR and another family member called EMS. When EMS arrived the patient was in ventricular fibrillation. Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing critical care. Two subsequent troponins were down trending.

Coronary

REBEL EM

NOVEMBER 30, 2023

Secondary Outcomes: Delayed hypotension, increased ICU stay, and other relevant outcomes. 4 studies remained, with a total of 571 patients with sepsis and a history of CHF Critical Result: The weighted OR for death was significantly higher in the <30 × 3 vs. 30 × 3 OR = 1.81, 95% CI = 1.13–2.89, 2.89, p = 0.01.

E-9-1-1

Critical Care Scenarios

NOVEMBER 15, 2020

” is always, ultimately, the main question of the EM provider. ICU time and ED time are different. In the ICU, we have a useful (albeit sometimes flexible) cap: our total number of beds.* This differs from the main questions of many of their consulting and admitting specialties.*

ICU

REBEL EM

AUGUST 12, 2024

When only using a lab value such as creatinine, the authors are making the end-result more heavily favored to only a lab-oriented outcome.

ICU

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch. 2009;338:b2085.

Defibrillator

REBEL EM

SEPTEMBER 5, 2022

Recent studies on patients requiring critical care have demonstrated that hyperoxia is harmful and instead we should be targeting normoxia (SpO2>93%). Background: Hypoxemia and hypoperfusion are important factors in outcomes after ROSC. Liberal O2 (PaO2 13 to 14kPa (98 to 105mmHg) Initial FiO2 set at 0.6 Liberal O2: 33.9%

ICU

REBEL EM

JULY 25, 2022

PrePARE Investigators; Pragmatic Critical Care Research Group. Effect of Fluid Bolus on Cardiovascular Collapse Among Critically Ill Adults Undergoing Tracheal Intubation (PrePARE): A Randomised Controlled Trial. appeared first on REBEL EM - Emergency Medicine Blog. No Bolus: 18.2% Absolute difference 2.8%; 95% CI -2.2%

ALS

EMDocs

APRIL 22, 2024

EMS verbalized concern to EPs that an “intracranial bleed” may have precipitated the event. Marino’s the ICU book, Wolters Kluwer Health, pgs 105-109, 4th ed., Critical Care Emergency Medicine, McGraw-Hill, pgs 129-132, 2nd ed., Tintinalli, J.E.

ED