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EM@3AM: Murine Typhus

EMDocs

The RUSH exam: Rapid Ultrasound in SHock in the evaluation of the critically lll. Food and Drug Administration. State of the art of diagnosis of rickettsial diseases: the use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus. Curr Opin Infect Dis. 2016 Oct;29(5):433-9. 2009.09.010.

EMS 101
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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. This can often lead to significant delays in proper resuscitation. Studies reviewed landmark-based CVC compared to IO; using IJ, subclavian, and femoral CVC sites.

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REBEL Cast Ep 118: The PROCOAG Trial – 4F-PCC for Trauma Patients?

RebelEM

Interventions such as early application of hemorrhage control, tranexamic acid, reduction of crystalloid fluid administration and balanced ratio blood product transfusion have improved many patients’ outcomes. However, mortality still remains high due to trauma-induced coagulopathy. Severe acute traumatic coagulopathy = PT >1.5

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ICU Physiology in 1000 Words: The Right Atrial Pressure Does Not Determine Cardiac Output – Part 2

PulmCCM

shows blood administration with a direct linear relationship between Pra and CO/VR; only Pmsf is varied here. Operating point guided resuscitation How do we make sense of this? The trick, I believe, lies in ‘operating point guided resuscitation’ [OPGR]. The ultrasound journal 2020, 12(1):1-12.

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Grand Rounds Recap 1.31.24

Taming the SRU

Ultrasound: Make “windows of access”. For blood product administration, PROPPR showed that 1:1:1 platelet, plasma, and pRBC administration led to earlier hemostasis along with less death due to blood loss and whole blood compared to separate blood product administration led to decreased death at 24 hours.

PPE 98
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Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Taming the SRU

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. Ultrasound Guided Peripheral IV (USGIV) Access anatomy of arm veins when considering USGIV. Place ultrasound machine on the opposite side of the bed to minimize neck strain.

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Hypothermic Cardiac Arrest: Pearls and Pitfalls

EMDocs

Hypothermic Arrest In general, hypothermic patients in cardiac arrest should be aggressively resuscitated. Patients can have excellent outcomes despite prolonged resuscitation. 2,3 If the patient meets criteria for resuscitation, they generally are not declared dead until their core temperature is above 32℃ (“warm and dead”).