An in-depth analysis of current topics in Emergency Medicine and Critical Care Medicine typically based upon our regular EM-CCM conference.
This month’s critical care mini-fellowship discussion was about the article, “Timing of Vasopressors in Septic Shock” as well as a review of the recent PROCESS, ARISE and PROMISE trials. Overall mortality rates in septic shock improved significantly from the 1990s to 2012 which coincides with several changes of practice including the Surviving Sepsis Campaign Read more…
Presented by: Dr. Niccole Bart Summary by: Dr. Kaycie Corburn The Case: 70 year old female with a long past medical history including a previous heart block with a pacemaker placed 20 years ago presents to the ED following a witnessed VF arrest with ROSC in the field within 5 minutes of Read more…
This block’s EM-CCM was a fantastic review of a commonly seen problem at its extreme. For the sake of brevity we will review: Renal failure associated metabolic derangements Indications for urgent dialysis Treatment of hyperkalemia- this is our bread and butter To bicarb or not to bicarb Not all troponinemia Read more…
EM-CCM Conference 1/21/15 Fire Exposure/Injuries Presented by: Dr. Danica Gomes Summary by: Dr. Kaycie Corburn The Case: 60 yo F unknown PMH BIBEMS from a house fire. There were known fatalities at this house fire. The patient was being ventilated by EMS personnel via BVM on arrival. Triage vitals revealed Read more…
To start: The ARDS Task Force paper from 2012 that revised the definition of Acute Respiratory Distress Syndrome from the 1994 American European Consensus Conference (AECC). The paper is most impressive as it approached definitions of illness by applying them to quantifiable outcomes. This idea bridges the gap between the clinical definitions Read more…
THE CASE: In a fictitious urban hospital a 28-year-old female, no pmhx, recently dx with “asthma”, presents with exertional shortness of breath for three months and an accompanying 40lb weight loss. Review of systems is negative for anxiety, wheezing, cough, chest pain, fevers, chills, night sweats, PE risk factors, recent Read more…
Cardiac Tamponade and Pericardiocentesis Summary by Dr. Kaycie Corburn Presented by Dr. Sally Bogoch The Case: 60 yo M PMH metastatic lung cancer, HTN, DM, former smoker presents to the ED with acute onset shortness of breath. Vitals in triage revealed tachypnea and tachycardia. Initial work-up revealed low voltage on EKG, Read more…
We discussed an informative and interesting review article on stroke management in October’s Critical Care Minifellowship meeting. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062315/ This article highlights some important points (that shed light on how complicated the brain truly is) and touches upon some interesting neurological trials. A few points to mention are: – The idea of Read more…
Still getting flack when you call for Ketamine in the resuscitation bay? Unsure if your colleagues from another mother are correct to chastise you? A recent systematic review evaluated the literature in relation to ICP as well as the outcomes that matter, disability and death. Give it a read here, so Read more…
EM-CCM Summary, 9/2/2014- The Sick Asthmatic. Presented by Dr. Elizabeth Abram The Case (As usual, this is a fictitious patient seen at a fictitious hospital called Janus General. Don’t believe me? I’m on staff there – see): 25 year old female with URI and asthma exacerbation. In the ED, the Read more…