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Malignant Catatonia

Core EM

Disposition to the psychiatry floor, medicine step down unit, or MICU should be guided by the degree of the patient’s vital sign abnormalities, the presence or absence of autonomic instability, and the patient’s response to therapy in the emergency room.

MICU 188
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Something Winter This Way Comes

EMS 12-Lead

MICU transport was unremarkable. Here the ST segments are not so deep, nor are the T waves so wide and bulky, because of improved coronary flow at the level of the occlusion. But the lesion is still active! This is demonstrated by lingering Hyperacute T waves in V2-V5 (i.e. hyperacute in their own rite despite attenuated ST segments).

STEMI 130
professionals

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My Burnout

The Overrun

I saw our shiny new MICU vehicles become like us. As things progressed, I saw the change in people, even some I worked with, as they stopped believing in science and data, and made a strand of unthinking protein choose a political ideology. Scarred, scratched up, dented, and check engine lights on.

MICU 52
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Non-Invasive Blood Pressure Monitoring in Critically Ill Adults?

REBEL EM

to 1.12; p = 0.03 for every change in 5ug/min Lower MAP Value: aOR 0.98; 95% CI 0.98 to 0.99; p <0.01 for every change in 1mmHg Higher BMI: aOR 1.04; 95% CI 1.01 to 1.09; p = 0.01 for an increase in 1 Increased Patient Age: aOR 1.31; 95% CI 1.30 to 1.37; p <0.01 for every 10 years Radial Arterial Line Location: aOR 1.74; 95% CI 1.16

ICU 104
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The EvK Trial: Ketamine vs Etomidate for Rapid Sequence Intubation

REBEL EM

In contrast, patients in the ketamine arm had higher rates of MICU admissions. The care team and outcome assessors were unblinded to the study arm, which may bias the results. The significance of 7-day survival is unclear. They were more functional at baseline, favoring etomidate which is the opposite of what investigators found.

MICU 52