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Issue #1: The Latest in Critical Care, 5/8/23

PulmCCM

Among 1150 patients considered high risk for aspiration at 15 French hospitals, those randomized to receive remifentanil had a higher rate of severe complications of intubation (aspiration, hypoxemia, hypotension, arrhythmia, cardiac arrest, or anaphylaxis), compared to those receiving neuromuscular blockade.

Stroke 52
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Annals of B Pod: Anti-Xa Overdose

Taming the SRU

She initially agreed to be transported to the hospital by ambulance, but jumped from the moving vehicle and was subsequently struck and pinned under the fuselage for 10-15 minutes. Hospital Course Based on the primary survey, no acute airway interventions were undertaken. The patient is agitated on a backboard with C-collar in place.

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Journal Club - Tranexamic Acid in Trauma

Downeast Emergency Medicine

We know that if administered too rapidly, it can lead to hypotension and other adverse effects including seizures, headaches, backache, abdominal pain, nausea, vomiting, diarrhea, fatigue, pulmonary embolism, deep vein thrombosis, anaphylaxis, impaired color vision, and other visual disturbances.[1] MI or stroke).

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Grand Rounds Recap 4.19.23

Taming the SRU

Trauma/Pre-Hosp Optimal Out-of-Hospital Blood Pressure in Major Traumatic Brain Injury: A Challenge to the Current Understanding of Hypotension Link: [link] Bottom Line: Think about maintaining normotension rather than simply avoiding hypotension in isolated TBI. and NPV(50%).

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Episode 20 - Emergency Department Management of North American Snake Envenomations

EB Medicine

Nachi: Right, but in Australia, not only are the snakes more venomous but the hospital transport distances are much longer, so, basically they sacrifice the limb to potentially save a life. Note that antivenom will NOT reverse anaphylaxis on its own. Regardless, the treatment is the same – epinephrine.

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Approach to Shock

Pediatric Emergency Playbook

Conversely, is the heart rate too slow – even if the stroke volume is sufficient, if there is severe bradycardia, then cardiac output -- which is in liters/min – is decreased. If so, treat the cause – perhaps this is a distributive problem due to anaphylaxis. If so, use 1 J/kg to synchronize cardiovert. mg/kg up to 0.5 Crit Care Med.

Shock 40
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Diagnostics: GI Bleeding

Taming the SRU

100U (30-60 min prior), 0.25-0.375/100U 100U (30-60 min prior), 0.25-0.375/100U