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…
Thanks to Dr. Corburn for presenting today’s Morning Report! Malignant MCA Syndrome Stats -Space occupying cerebral edema resulting after MCA stroke -Occurs in 10% of all strokes -About 13% of proximal MCA strokes experience severe cerebral edema Pathophysiology -Cytotoxic edema begins within hours of the stroke and Read more…
A CASE: A 40 y/o black homeless man presents with difficulty walking secondary to extreme left lower extremity pain. On exam, the patient is afebrile, HR 105, RR 20, BP 120/65. His extremity is swollen, warm, erythematous and extremely tender to touch. A sepsis code is called; the patient is Read more…
TPA for MI when PCI is not available – recommended so thoroughly it’s in textbooks. TPA for clotted AV fistulas – surgeons do it. TPA in stroke…not going anywhere near it. TPA for PE…Interested? After a lit search [1] done under the tutelage of Dr. Shahriar Zehtabchi, here’s 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…
Here’s Dr. Ammon with a great Halloween edition of Morning Report! DELIRIUM TREMENS Most severe form of alcohol withdrawl manifested by AMS (global confusion) and sympathetic overdrive (autonomic hyperactivity). CHRONIC ETOH -> CNS DEPESSANT -> ETOH-GABA -> inhibitory effect…. No ETOH -> OVERACTIVE CNS -> CARDIOVASCULAR COMPROMISE… 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…
That moment when an idea strikes you. Something stutters the laminar flow of the mind. A mental murmur, perhaps. It’s that hiccup that alerts you that something’s up, something needs to be reassessed. This happened to me at Janus General, where Grock works. Neurology clinic referred a patient to 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…