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BIPAP IPAP: Higher is Better?

EM Literature of Note

In this unblinded, randomized-controlled trial, patients with acute exacerbations of COPD received traditional NIPPV with inspiratory pressures <18 cmH20 or “high-intensity” NIPPV, with airway pressures titrated up to 20-30 cmH20. This trial, the HAPPEN trial, looks at a little bit different approach.

COPD 93
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SGEM#447: Just What I Needed – Preoxygenation Prior To Intubation

The Skeptics' Guide to EM

Case: A 70-year-old man presents to the emergency department (ED) with an exacerbation of COPD. They do not provide positive pressure or ventilatory support, and the actual FiO2 delivered can be significantly lower than expected if the mask does not fit well.

COPD 91
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Massive Hemoptysis

EM SIM Cases

Koo works as an Emergency Physician and Assistant Professor of Emergency Medicine at MedStar Health and Georgetown University. He has experience using simulation to train combat medics, resistive team dynamics, and emergency medicine residents alike.

COPD 52
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BPAP vs AVAPS for Hypercapnic Respiratory Failure in the ED

RebelEM

Comparison of BPAP S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: A Randomized Controlled Trial. AVAPS may be useful, but we still need a well conducted RCT to find out if it is (i.e Paper: Goren NZ et al. Balkan Med J 2021. AVAPS: 0.07 AVAPS: 10.20

COPD 133
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Diagnostics and Therapeutics: Pneumomediastinum

Taming the SRU

Most common triggers include respiratory conditions such as asthma, COPD, and pneumonia which can lead to forceful coughing -Other common triggers include forceful exertion, severe coughing or vomiting, asthma exacerbation, intense physical activity, or Valsalva maneuvers (e.g., West J Emerg Med. weightlifting, childbirth) [4].

COPD 78
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Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

RebelEM

It can be used to distinguish between various conditions, including chronic obstructive pulmonary disease (COPD) exacerbation, acute heart failure (AHF), pleural effusion, pulmonary edema, pericardial effusion, pneumothorax, and pneumonia [2,3]. Patients : Compared standard of care to serial US plus stand care in patients with dyspnea.

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An elderly male with acute altered mental status and huge ST Elevation

Dr. Smith's ECG Blog

A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. Vital signs were within normal limits on arrival to the Emergency Department. Written by Bobby Nicholson What do you think of this “STEMI”? Blood glucose was not low at 162 mg/dL.

EKG/ECG 94