Archive for category Critical Care
ECMO in the ED, by the ED
Posted by Scott D. Weingart, MD FACEP in Critical Care on September 26th, 2011
Resuscitative Extra-Corporeal Life Support for Cardiac Arrest
Joe Bellezzo, MD along with his partner-in-crime, Zack Shinar, MD have started an ED ECMO service at Sharp Memorial Hospital in San Diego. I am so jealous! In this episode of the podcast, I get to talk to Joe about how it works.
Part III of the Emanuel Rivers Sepsis Talk is now published
Posted by Scott D. Weingart, MD FACEP in Critical Care on September 13th, 2011
Dr. Emanuel Rivers brought the concept of aggressive therapies for sepsis down to the Emergency Department with his seminal article on EGDT published in the NEJM in 2001. We were lucky enough to get an hour of his time to do a conference call with the NYC STOP Sepsis collaborative.
I broke the ~1 hour lecture into 3 parts.
If you haven’t already, check out Part I and Part II.
In Part III, Dr. Rivers discusses:
- Protein C
- Can you do EGDT in small community EDs
- How do you handle the tachycardic patient with severe sepsis
- Steroids in the ED
- Procalcitonin
Dr. Emanuel Rivers on Severe Sepsis – Part I
Posted by Scott D. Weingart, MD FACEP in Critical Care on August 29th, 2011
Part I of Dr. Rivers’ talk on Severe Sepsis
Dr. Emanuel Rivers brought the concept of aggressive therapies for sepsis down to the Emergency Department with his seminal article on EGDT published in the NEJM in 2001. We were lucky enough to get an hour of his time to do a conference call with the NYC STOP Sepsis collaborative.
I broke the ~1 hour lecture into 3 parts. In Part I, Dr. Rivers discusses…
Organ Donation in the Emergency Department
Posted by Scott D. Weingart, MD FACEP in Critical Care on July 27th, 2011
Organ Donation in the Emergency Department
Though it may not seem as important as some of the things we do in ED Critical Care, managing the potential organ donor can lead to many lives saved. In this episode I interview Isaac Tawil, an Emergency Intensivist of University of New Mexico Health Sciences and associate medical director of New Mexico Organ Donor Services. We discuss why it is so important to not blow off the call to organ donor services, how to conduct a preliminary brain death exam, and the misconceptions on who can and cannot donate viable organs.
Fibrinolysis in PE
Posted by Scott D. Weingart, MD FACEP in Critical Care on July 11th, 2011
Fibrinolysis in Pulmonary Embolism with Dr. Jeff Kline
Jeff Kline is the master of all things pulmonary embolism in emergency medicine. This is a lecture he gave on fibrinolysis for PE. He discusses both massive and submassive PE. This lecture was a game-changer for me and after hearing it, I’ve had to rethink the treatment of PEs in the ED.
Choose the Solution based on the Problem – Acid Base Part 4
Posted by Scott D. Weingart, MD FACEP in Critical Care on June 27th, 2011
The Acid Base of Fluids
This is Part 4 of the Acid Base saga. In this episode, I discuss the acid base effects of fluids and when and how to use sodium bicarbonate.
If you haven’t checked out the previous episodes, you should definitely do that first:
- Part I lays out the background of the quantitative approach
- Part II puts it in mathematical terms to allow calculation of acid base status
- Part III takes you through some real world examples
[Click Here to Read More and to Hear the Podcast]
The Mind of Resus Docs: Logistics over Strategy
Posted by Scott D. Weingart, MD FACEP in Critical Care on June 7th, 2011
amateurs discuss strategy; experts discuss logistics
–Napoleon?
This Part I of the Mind of a Resus Doc Series, in which we delve into the philosophies that make a good resuscitationist. In this episode we discuss the benefits of considering logistics rather than strategy.
[Click Here to Read More and to Hear the Podcast]
photo by kaptain kobold
Left Bundle Branch Block (LBBB) doesn’t = STEMI!
Posted by Scott D. Weingart, MD FACEP in Critical Care on May 23rd, 2011
A few months ago, we had Dr. Stephen Smith on the podcast to discuss a variety of EKG issues. Dr. Smith has an EKG blog that is required reading for every ED and ICU doc. This is Part II and I think it discusses an incredibly important issue: right now major medical societies including the AHA and ACEP are asking us to fibrinolyse or PCI patients with new or presumed new LBBB. However, your interventionalists will tell you that this strategy is a ridiculous waste given how few acute occlusions will actually be found. Why this discrepancy?
Acid Base: Part II
Posted by Scott D. Weingart, MD FACEP in Critical Care on April 25th, 2011
Part I was hard; Part II is even tougher. But I think there is light at the end of the tunnel. In this episode we go through the math of an acid-base scenario. You will begin to understand the quantitative approach, but you’ll also understand the standard approach. We will discuss why the “normal anion gap” is a myth.
Acid Base: Part I
Posted by Scott D. Weingart, MD FACEP in Critical Care on April 11th, 2011
I have spoken about it for a while, but I’ve finally gotten it done: the acid-base podcast. The podcast is going to be in 3 or 4 parts. They are segmented from a lecture I gave to my residents recently.
This lecture discusses a quantitative approach to acid base management. This is also known as the Fencl-Stewart approach, the strong-ion approach or the physicochemical approach. It provides explanations for why acid base disorders occur in human pathophysiology. The classic method used in the USA is the Henderson-Hasselbalch (misspelled on my slides) approach. I find this method to provide no comprehensive explanation for why things are as they are. Through the quantitative approach, you can also understand the H&H approach and continue to use it with new insight.
