“Sepsis Code to Resus 1.” Your charge nurse comes out of her office, “Doc, you know that’s the cardiac arrest patient right? They’re not febrile. Why are we ordering antibiotics?” Despite all the hoopla and controversy surrounding mandated CMS guidelines surrounding the Surviving Sepsis Campaign, there’s limited evidence that antibiotics Read more…
The Ultrasound Mini-Fellowship (Team Sono) met last month to discuss TransEsophageal Echocardiography (TEE) in cardiac arrest. We specifically discussed two major papers in the TEE literature discussing TEE during cardiac arrest. First, thank you to all of our amazing faculty (Drs. Maurelus, Ozaki, Aherne, Mahalingham, Balakrishnan, Kim, Cutright, Reisman, Beyda, Read more…
The notification phone rings: “Cardiac arrest, intubated, ETA 3 minutes.” Take a breath. You look around and notice you have a loaded team! EMS rolls in and moves that patient to the stretcher. Your awesome nurses get IV access on the first try while you promptly assemble the LUCAS device Read more…
This article will not attempt to wade into the pathophysiology of acid-base disorders. From reading the nephrology literature, it seems that this topic is more closely akin to theoretical physics than the sturdy biochemistry I learned in college. Researchers can’t even agree on how to define acidosis, much less what Read more…
We are all going to get this notification at some point. You’ll be wandering around the ED doing lunges out of boredom, and the phone will ring …. “61-year-old male found down in VF, shocked x 3 without ROSC, intubated, IV access, epi x 3, amio. ETA 5 minutes.” …You’ll Read more…
It’s 15 minutes from change of shift, and you are recovering from a busy overnight in the critical care area of the ED. Suddenly, an intubated patient rolls in the door without prior notification, and EMS is performing chest compressions. “Intubated… three rounds of epinephrine and one round of bicarb Read more…
This EM-Critical Care Medicine case presentation focused on a very complex resuscitation with multiple facets. The case is notable because it includes most, if not all, of the factors we should consider when worrying about a peri-intubation arrest. Let’s recap the initial case and apply what was learned in conference Read more…
You decide to take a break from the city and moonlight in a small rural hospital. You think you’ll be chilling for the night seeing urinary tract infections, or maybe you’ll finally see that snake bite you never thought you’d see. The night starts off slowly with a steady stream Read more…
Case A 35 year-old female with no PMH is brought in by her mother for acting strangely. Mother notes the patient has had two days of cough and cold-like symptoms with nausea today. She slept all day and upon waking, she was confused and not making any sense. +fever, +epigastric Read more…
A 29-year-old male comes to your ED complaining of pressure-like left sided chest pain that started an hour after he smoked marijuana. He has never felt anything like this before. He has no medical problems, surgeries, medications, allergies, and has no family history of heart disease. He does not smoke cigarettes, Read more…