Critical Care

Critically Appraised Topic: Does pre-charging the defibrillator before rhythm analysis improve hands-off time in patients suffering cardiac arrest with shockable rhythm?

Dr. Jacob C. Martin, M.D. discusses two papers on pre-charging during cardiac arrest. 

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Critical Cases - Predicting Failure of NIPPV!

A 76 year old male presents with confusion, cough, and fever. He remains hypoxic in the 80s on nasal canula. Your nurse suggests non-invasive positive pressure ventilation to improve oxygenation. How likely is this strategy to maintain acceptable oxygenation? What are the chance the patient will progress to the need for intubation? 

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Critical Cases - Hypertensive Emergency!

A 48 year old male presents with complaints of blurry vision. His triage blood pressure catches your eye: 290/120. "Pretty high," you mutter to yourself "but am I supposed to treat it? If so, with what? How fast should that pressure come down?" Time for a crash review of hypertensive emergency....

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Critical Cases - Anaphylaxis After IV Contrast Administration!

A 79 year old female is sent in by urgent care for a CT scan of the chest after a plain film demonstrates a sternal fracture after MVC. "No problem," you think as you order the CT and go about your shift. A few hours later, however, you hear the dreaded "I need a doctor in here!" from your patient's room....

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Basics of PRESSORS, one bite at a time

PRESSORS! This post was originally submitted as a summary of many different pressors. It is great to think about them all together, but maybe not digestible in a single bite. If you want to learn about them all at once, watch Dr. Di Taranti's lecture from conference last month. Instead, we will break them down one by one, focusing on a different pressor each week, with the summary table re-presented each week to help compare. Use this as spaced repetition. Each week, remind yourself what the different receptors do. Ask yourself how one medication is different from the last. Ask yourself what dose you would start with and which patients you would use it for.  Review all the pressors, but do it slowly, one bite at a time, and ease yourself in.

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