Handtevy

JUNE 20, 2025

Early bolus epinephrine administration during pediatric cardiopulmonary resuscitation for bradycardia with poor perfusion: an ICU-resuscitation study. This moment is more than just a guideline change—it’s a validation of the relentless pursuit of evidence over tradition. Resuscitation. 2020;149:200–207. doi:10.1016/j.resuscitation.2019.12.032

Epinephrine 52

Epinephrine CPR Life Support ALS 52

ACEP Now

JUNE 29, 2025

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). Known hypotension, as a bridge to a continuous infusion of a pressor. Using push-dose pressors can be your lifeline while waiting for the infusion bag to arrive.

Emergency Department 59

Emergency Department E-9-1-1 Epinephrine Critical Care 59

EMDocs

DECEMBER 18, 2024

fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold

E-9-1-1 101

E-9-1-1 Emergency Department ICU ED 101

Dr. Smith's ECG Blog

JANUARY 15, 2025

Pt was extubated a day later and continues her recovery in the ICU. Pt had thrombotic nearly occlusive LM lesion with TIMI 1 flow in the LAD, Ramus, and Left Circumflex, and she was transferred for emergency CABG x 3. Etiology possible thromboembolic and less likely due to atherosclerosis or plaque rupture. We are hopeful for her recovery.

STEMI 52

STEMI ICU ED Ambulance 52

REBEL EM

NOVEMBER 25, 2024

Intubation performed in all settings (out-of-hospital, emergency department, ICU, and operating room). Clinically Diverse Patient Population : The study included patients from varied clinical settings (ED, ICU, OR, and pre-hospital). Randomized controlled trials or comparative non-randomized observational studies. airway scope).

Operating Room 92

Operating Room Emergency Department ICU ALS 92

REBEL EM

DECEMBER 23, 2024

The characteristics that were significantly different between the LR and NS exposure groups race, organ dysfunction at presentation, ICU admission, hemoglobin SS genotype, discharge year, and hydroxyurea use were appropriately included as confounders in the TMLE analysis.

ALS 116

ALS ED ACS EMR 116

ACEP Now

JANUARY 4, 2025

Clarke took from 19781980 provide a glimpse into working in an emergency department in the years the specialty was being established. At first glance, one might notice the clothesnurses in white dresses and doctors in wide ties or bellbottom jeansor the hairafros, sideburns, and mustaches aplenty. Now, we have ultrasound or CT scans to confirm.

ED 52

ED Emergency Department Ambulance CPR 52

The Skeptics' Guide to EM

JUNE 15, 2025

After managing her sepsis, her oxygenation remains poor, with saturations in the 88-92% range despite supplemental oxygen via a nonrebreather mask, and she now shows signs of worsening fatigue. Exclusions: Studies involving reviews, conference abstracts, case reports, or lacking full text. strategies.

ICU 244

ICU ALS OR 244

Broome Docs

JANUARY 27, 2025

Welcome to the first episode of the Broomedocs podcast for 2025. Justin and I are back for more nerdy goodness to make you smarter in the Resus room, or at a pub trivia night more likley… wether it is about salt correction, dissection or infection we can help you out! Listen in and learn! Dimer is useful in the low risk group. Emerg Med J.

ED 100

ED OR ACS Critical Care 100

REBEL EM

NOVEMBER 11, 2024

Background: Patients with sepsis are routinely treated with empiric broad-spectrum antibiotics while awaiting source identification, as recommended by the surviving sepsis campaign.2 2 Vancomycin, in combination with either piperacillin-tazobactam or cefepime, is commonly used for empiric treatment in these cases. In 2021, Buckley et.

E-9-1-1 93

E-9-1-1 ICU ALS Critical Care 93

EMDocs

JANUARY 6, 2025

History of Present Illness The collateral history indicates that her symptoms began one week into her journey, but medical care was inaccessible at the time. The family reports no history of food allergies, insect bites, or contact with sick individuals. The patient did not receive pre-travel prophylaxis for malaria, hepatitis A, or yellow fever.

ED 74

ED E-9-1-1 ALS Frozen Plasma 74

Don't Forget the Bubbles

MARCH 21, 2025

Effectiveness of Nasal High-Flow Oxygen during apnoea on Hypoxaemia and Intubation Success in Paediatric Emergency and ICU Settings: a randomised, controlled, open-label trial. Thats exactly what Shane George et al. George S, Williams T, Humphreys S, et al. Lancet Respiratory Medicine.

ICU 98

ICU Critical Care ED OR 98

Critical Care Scenarios

APRIL 16, 2025

We discuss the basics of EEG in the ICU, including when to do it, selecting the appropriate study, and the basics of bedside interpretation, with Carolina B Maciel, MD, MSCR, FAAN, triple boarded in neurology, neurocritical care, and critical care EEG. Learn more at the Intensive Care Academy! Find us on Patreon here! Find us on Patreon here!

ICU 164

ICU Critical Care ACS OR 164

JEMS

JUNE 13, 2025

In humans, its pharmacologic relative dexmedetomidine is used for procedural sedation and ICU management, but medetomidine itself has no approved human indication. Medetomidine is a central alpha-2 adrenergic agonist used in veterinary medicine to induce sedation and analgesia. 2 Withdrawal from medetomidine presents a different challenge.

Naloxone 124

Naloxone Overdose Mobile Integrated Health Community Paramedicine 124

The Bottom Line

JUNE 27, 2025

Skip to content Twitter Google+ Facebook Reddit RSS The Bottom Line A compendium of critical appraisals in Intensive Care Medicine research and related specialties Home About Us Summaries Intensive Care Medicine Emergency Medicine Peri-operative Medicine Blog News EBM Editorial Submit a review Wessex ICS You are here: Home Blog Critical Care Evidence (..)

Critical Care 69

Critical Care ICU Coronary OR 69

EMDocs

JULY 21, 2025

Lower intubation, need for BPAP and ICU admission in bolus group (Levy 2007). SCAPE differs in several significant ways: rapid onset (hours), respiratory distress, severe HTN, may or may not be systemically volume overload. Meta-analyses demonstrate reduced need for intubation, improved survival, improved respiratory indices (e.g.,

E-9-1-1 88

E-9-1-1 ALS Emergency Department OR 88

REBEL EM

MAY 19, 2025

1 Three small noninferiority RCTs suggested that 7 days of antibiotics may be sufficient for patients with gram-negative bacteremiabut these trials had notable limitations: they excluded ICU patients, included only clinically improving individuals, and did not assess gram-positive infections. male Setting at enrollment: ICU: 55.0%

E-9-1-1 54

E-9-1-1 ICU ALS OR 54

ACEP Now

JUNE 24, 2025

Value-Based Care in Emergency Medicine The transition to value-based care has been slower than anticipated, particularly for specialties like emergency medicine that need more predefined patient populations or well-defined episodes of care. However, emergency physicians have made significant strides in recent years. No external validation.

ED 52

ED ICU OR Emergency Department 52

Dr. Smith's ECG Blog

NOVEMBER 16, 2016

She was admitted to the ICU on an amiodarone drip and continued to improve. Here is her initial ED 12-lead ECG: There is atrial fibrillation with a rate of approximately 114. There is extreme ST depression in multiple leads and ST elevation in aVR, suggesting left main and/or 3 vessel disease ischemia. Is this Acute Coronary Syndrome?

ACS 52

ACS Coronary ICU STEMI 52

GEDC

JUNE 30, 2025

Throughout her career as a pharmacist, Jennifer Esch, PharmD, MBA, BCPS, has worked in a variety of hospital settings from the ICU to the emergency department. This series highlights members of the GEDC community who are clinical champions for older adults in the emergency department. That was a whole lot better than I expected,” Esch said.

Emergency Department 52

Emergency Department ED ICU OR 52

EMDocs

JUNE 21, 2025

PMID: 40378193 #2: OPTPRESS – High MAP Goal in Older Patients with Septic Shock Spoon Feed — This randomized control trial of older ICU patients with septic shock in Japan showed higher mortality and more frequent adverse events in patients randomized to a high MAP goal (80-85 mmHg) compared to usual care (65-70 mmHg). Clin Infect Dis.

ICU 47

ICU OR 47

EMDocs

JULY 26, 2025

9 Consider ICU if related to thyrotoxicosis as these patients require monitoring for cardiac arrhythmias. Hip flexion ⅖ bilaterally, knee extension ⅗ bilaterally, plantar and dorsiflexion ⅘. Bilateral upper extremities shoulder flexion, elbow flexion, and extension 5/5. MSK: no rashes or lesions appreciated. mEq/L Magnesium: 1.33

E-9-1-1 75

E-9-1-1 EMS ALS ED 75

Core EM

JULY 1, 2025

Recognize pulmonary-renal syndromes early. Initiate high-dose steroids immediately for unstable patients without waiting for ANCA results. GPA is rare but life-threatening – early recognition saves lives.

Plasma 130

Plasma ICU ED OR 130

The Bottom Line

JUNE 11, 2025

Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU Gunst et al. N Engl J Med 2023;389:1180-1190 DOI: 10.1056/NEJMoa2304855 Clinical Question In ICU patients not receiving early parenteral nutrition, does liberal glucose control (initiating insulin when blood glucose level [BGL] >11.9 to 6.1 […]

ICU 65

ICU ALS OR 65

EMDocs

JULY 23, 2025

She is intubated, resuscitated and admitted to the ICU. An abdominal CT is ordered, during which the patient vomits, aspirates, develops bradycardia and has a PEA cardiac arrest. The non-contrast CT scan shows a very large, distended fluid-filled stomach above the diaphragm suggesting the presence of a gastric volvulus.

ICU 78

ICU ED Ambulance OR 78

EMDocs

JUNE 28, 2025

On physical exam, the patient is lethargic, has nasal flaring, and is using accessory muscles to breathe. Lung sounds are clear. On cardiac exam, there is normal rate and rhythm without murmur, rubs, or gallops. His capillary refill is 2 seconds. His surgical incision looks clean and without any signs of infection.

EMS 78

EMS E-9-1-1 Overdose ALS 78

Dr. Smith's ECG Blog

FEBRUARY 10, 2025

and the patient was given more insulin/dextrose/calcium and admitted to ICU. Two hours later the patient became somnolent and the monitor showed the following rapid changes: ECG after ROSC Repeat K was 6.4 A good reminder of recommendations for calcium for either K>6 with any ECG changes (when the patient was first seen) or K>6.5

ALS 125

ALS ED ICU OR 125

EMDocs

DECEMBER 6, 2024

Children without vomiting within 6 hours of iron ingestion will almost never have significant toxic effects. 6 Can see subsequent electrolyte disturbances and dehydration related to severity of GI symptoms. In severe toxicity, hematemesis, melena, or hematochezia may occur. Be wary of this stage. This stage does not always occur. 2 L/hr in adults.

E-9-1-1 96

E-9-1-1 Frozen Plasma Plasma Overdose 96

EMDocs

MARCH 4, 2025

Can be a smoldering infection in patients with immunocompromising conditions. Consider cryptococcus meningitis in these patients. Recommended testing: Serum lab tests are commonly obtained, but they are not helpful in ruling in or out bacterial meningitis. Cerebrospinal fluid analysis (ideally within 1 hour of presentation to ED) is necessary.

ALS 79

ALS ICU ED OR 79

Critical Care Scenarios

JUNE 11, 2025

Octreotide is not the treatment of choice for HRS in the ICU; use norepinephrine and titrate up until you see an increase in urine output (or it doesn’t work). Terlipressin works too but is pricey and more appropriate for outside the ICU. Terlipressin works too but is pricey and more appropriate for outside the ICU.

ICU 139

ICU OR 139

EMDocs

JUNE 11, 2025

The ICU team comes down and rapidly admits the patient. The GI team is standing by in the ICU ready to do an emergent scope. The patient’s initial high sensitivity troponin was 7 ng/L and was trended by the ICU team upstairs. He was so weak that we had to carry him out of the bathroom and then sprinted over here. Any ideas?”

Coronary 80

Coronary STEMI ICU EMS 80

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 110

Critical Care ICU ED Emergency Department 110

EMCrit Project

OCTOBER 24, 2023

Today we'll walk through some interesting bits of the new IDSA/SCCM guideline on evaluation of new fever in the adult ICU patient (available free here). how should temperature be evaluated? This is frankly a mess. Bladder catheter or esophageal probe are best, but usually not used.

ICU 138

ICU OR 138

Life in the Fastlane

AUGUST 26, 2024

Caleb Lin Hyperbaric Oxygen for the ICU Patient OVERVIEW INTENSIVE CARE INDICATIONS PRACTICAL ISSUES IN CRITICAL CARE Consideration & Prior to Treatment In the Chamber A: ETT cuff to be filled with sterile water or connected to dynamic cuff inflator B: Titrate ventilation to PaCO2, note that EtCO2 is not linearly proportionate at higher pressures (..)

ICU 101

ICU Critical Care OR 101

Core EM

JANUARY 25, 2024

The standard of care of treating DKA is fluid resuscitation, electrolyte management, and intravenous insulin infusion in the intensive care unit (ICU) setting for close glucose and electrolyte monitoring. Recent research aims at investigating the treatment of DKA with subcutaneous insulin in non-ICU settings. Image from cited article.

ICU 246

ICU EMS ED OR 246

The Skeptics' Guide to EM

SEPTEMBER 2, 2023

The patient states he has had multiple “diabetic emergencies” in the past and usually ends up in the intensive care unit (ICU) on a drip. He is wondering, “Hey doc, do I have to go back to the ICU strapped to an IV pole?” However, the ICU is full and the patient will likely be boarding in your ED for a bit before coming upstairs.

ICU 273

ICU ED Critical Care ALS 273

The Skeptics' Guide to EM

JUNE 12, 2022

He is board certified […] The post SGEM#368: Just A Normal Saline Day in the ICU – The PLUS Study first appeared on The Skeptics Guide to Emergency Medicine. Then, the BaSICS trial (a multicentred RCT done in 75 Brazilian ICUs) came along and compared saline to Plasma-Lyte at what the authors deemed slow and fast infusion rates.

ICU 132

ICU Plasma Critical Care ALS 132