A Bad Sedation Package Leaves your Patient Trapped in a Nightmare

A Bad Sedation Package Leaves your Patient Trapped in a Nightmare

Pushing some ativan followed by vecuronium is no longer an acceptable strategy to manage post-intubation sedation. A good analgesia and sedation package is essential if you care about your patient's comfort and well-being.... read more

Sick Meningitis, POCUS for Pneumoperitoneum, and Treatment of CHS

Sick Meningitis, POCUS for Pneumoperitoneum, and Treatment of CHS

Today on the emDocs cast with Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER) we cover three posts: the sick meningitis patient, ultrasound for pneumoperitoneum, and treatment of cannabiniod hyperemesis syndrome. Part... read more

Comparing Procedural Amnesia and Respiratory Depression vs. MS and DS with Propofol

Comparing Procedural Amnesia and Respiratory Depression vs. MS and DS with Propofol

Targeting moderate sedation (MS) or deep sedation (DS) did not reliably result in the intended sedation level. Targeting MS, however, resulted in a lower rate of total AREs and fewer patients had multiple AREs with no difference... read more

Intracerebral Hemorrhage (ICH)

Intracerebral Hemorrhage (ICH)

For most patients, the best treatment seems to be high-quality supportive care. Aggressive interventions (e.g., causing dramatic drops in blood pressure and "prophylactic" hypertonic saline) may cause more harm than good. Cerebellar... read more

International PICU COVID-19 Collaboration Conference Call

International PICU COVID-19 Collaboration Conference Call

This episode is an international collaborative conference call hosted by Dr. Jeffrey Burns of Boston Children's Hospital and Harvard Medical School. Featured speakers are Drs. Daniel Barouch, Trevor Duke, and Robinder Khemani,... read more

Unfractionated Heparin (UFH), LMWH, Fondaparinux, Argatroban, and Bivalirudin

Unfractionated Heparin (UFH), LMWH, Fondaparinux, Argatroban, and Bivalirudin

Unfractionated heparin (UFH) binds to anti-thrombin III (AT-III), which enhances antithrombin's inhibition of several coagulation factors – especially factor Xa and factor IIa (thrombin). Low Molecular-Weight Heparin... read more

Respiratory Physiology of Mechanically Ventilated Patients with COVID-19

Respiratory Physiology of Mechanically Ventilated Patients with COVID-19

In this "Breathe Easy Critical Perspective" podcast, Dr. Dominique Pepper interviews Drs. Jehan Alladina and Corey Hardin. They discuss the respiratory physiology of mechanically ventilated patients with COVID-19. Dr.... read more

COVID-19: Thrombosis and Anticoagulation

COVID-19: Thrombosis and Anticoagulation

Early reports have shown that COVID-19 is most likely causing a hypercoagulable state, however the prevalence of acute VTE and exactly how to treat it is an evolving area. Limited data suggest pulmonary microvascular thrombosis... read more

Trying Not to Intubate Early & Why ARDSnet may be the Wrong Ventilator Paradigm

Trying Not to Intubate Early & Why ARDSnet may be the Wrong Ventilator Paradigm

Many of us have been working under the paradigm that COVID-19 PNA eventually develops into ARDS in the sickest patients. It appears to me that these patients don’t fit into this paradigm. Many have normal to high compliance... read more

COVID-19 and Critical Care

COVID-19 and Critical Care

In this podcast, we talk about the clinical journey of a COVID-19 patient and some insights from the critical care unit. There are some concepts here that we probably don't do full justice to in the time we had, so here are... read more

Rationing of Critical Care and Ventilators in COVID19

Rationing of Critical Care and Ventilators in COVID19

In many hospitals ventilators have become a scarce or non-existent resource in the face of the COVID19 pandemic. We need a ethical structure to allocate ventilators and other scarce resources. ... read more

Preparing for the COVID-19 Pandemic Podcast

Preparing for the COVID-19 Pandemic Podcast

In the midst of the global COVID-19 pandemic, this episode focuses on the pandemic planning all ICUs should be doing – if they haven’t already been overwhelmed. This week a Working Group of 30 colleagues released the... read more

COVID-19 Situation in Japan

COVID-19 Situation in Japan

Dr Adrian Wong speaks to Prof Satoru Hashimoto on the #COVID19 situation in Japan in this ESICM podcast. Dr Adrian Wong is a consultant in critical care in King’s College Hospital, London. He is the chair of the Editorial... read more

Life Following Pediatric Septic Shock

Life Following Pediatric Septic Shock

Margaret M. Parker, MD, MCCM, and Jerry J. Zimmerman, MD, PhD, FCCM, talk about the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock. This... read more

Sepsis: The Hour-1 Bundle, the Future of Research, and More

Sepsis: The Hour-1 Bundle, the Future of Research, and More

Margaret M. Parker, MD, MCCM, and Mitchell M. Levy, MD, MCCM discuss the Hour-1 Bundle, the controversies of the Surviving Sepsis Campaign, and the future of sepsis. Drs. Parker and Levy go beyond the bundle to talk about... read more

Risk for Mortality in Critically Ill Children Needing RRT

Risk for Mortality in Critically Ill Children Needing RRT

Margaret M. Parker, MD, MCCM, speaks with Danny Hames, MD, on his article titled "Risk Factors for Mortality in Critically Ill Children Requiring Renal Replacement Therapy" published in the November 2019 issue of Pediatric... read more

Cardiogenic Shock – The Next Level & Mechanical Circulatory Support

Cardiogenic Shock – The Next Level & Mechanical Circulatory Support

We could center this discussion about the SCAI paper that came out (attached). A nice collaborative expert panel piece outlining a CS pyramid used quickly at the bedside in the ED, ICU, Cath Lab, etc to help us identify these... read more