You are working at a tertiary care center and a 55-year-old woman is transferred to you from an outside hospital for severe persistent thrombocytopenia of unknown origin. On arrival, she is mildly confused and tachycardic. The platelet count is 7K and the hemoglobin is 5.8. Peripheral blood smear demonstrates schistocytes consistent with microangiopathic hemolytic anemia. The diagnosis of thrombotic thrombocytopenic purpura (TTP) is suspected. TTP is a hematologic emergency: what are the next steps in management?
As the COVID epidemic continues with cases rising, managing patients with hypoxemia will continue to be challenging. This video with Dr. Matt Siuba and myself will discuss a few strategies to manage the patient with refractory hypoxemia.
The video is here
Pericardiocentesis is a rarely performed, but potentially life-saving procedure. Commerical models are prohibitively expensive, but students and residents (and critical care fellows) still need to learn the mechanics, ideally with an ultrasound compatibile model. This week's post gives a step by step guide towards making a cheap, easy to fabricate phantom based on this fantastic paper published in the Journal of Emergency Medicne 2012: https://www.ncbi.nlm.nih.gov/pubmed/21925818