Following a severe brain injury the goal of the clinician is to prevent secondary brain injury. This entails increasing oxygen delivery to the brain by preventing hypoxia and increasing cerebral perfusion. Hyperosmolar therapy, including mannitol and hypertonic saline, is often used to decrease ICP.
This article intends to focus on a particular aspect of the pathophysiology of salicylate toxicity which is correctable, can improve mental status, and potentially stave off intubation: hypoglycorrhachia.
When patients present to the Emergency Department with acute upper GI bleeding, the natural inclination is to quickly pull the transfusion trigger. However, a 2013 study gives us pause:
Dynamic hyperinflation (autoPEEP, air trapping, etc.) is a process leading to an increase in end-expiratory lung volumes and increased airway pressures. This process may occur secondary to obstructive lung pathology and/or an increase in minute-ventilation without sufficient time for expiration. The pathologic effects of dynamic hyperinflation include an increased work-of-breathing, barotrauma, pneumothorax, and an increase in intrathoracic pressure leading to a decrease in cardiac output and possible hemodynamic collapse. Rapid identification of this process is crucial for reversing it.
A high-yield introduction to the use of ECMO in hypothermic patients!
#1 Rule: Do NOT take control of the patient’s airway unless absolutely necessary!
Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare but significant causes of morbidity and mortality in both traumatic and medical ICU patients.
In the setting of a severe asthma exacerbation that is refractory to medical mangagment and noninvasive ventilation, mechanical ventilation can be life-saving. However, the ventilator can quickly kill your patient if careful thought is not taken to address the unique respiratory needs and pulmonary physiology inherent to severe asthma.
When treating acute, wide-complex tachycardia deemed to be stable, monomorphic ventricular tachycardia, two agents remain prevalent among emergency medicine physicians: amiodarone and procainamide. This post examines some of the evidence behind these agents in achieving successful conversion of stable, monomoprhic VT.
Succinylcholine and its use during rapid sequence intubation in the pediatric population remains controversial. Here is a brief review of where that controversy comes from!
