There are many approaches and therapeutic options in critical care that do not have a strong evidence base to guide us. We use our clinical judgement, gestalt and basic principles to make rapid decisions. This blog explores therapeutic options to various challenging critical care scenarios through an interactive case-based, Q&A framework. The case unfolds in a step-wise manner, as it would in real practice, and integrates opinions from critical care providers, not only from STARS, but from around the world. Each blog includes an open peer review from an expert on the given topic. Welcome to CritCases!
In this CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases we discuss a challenging case of pulmonary hypertension where a fine balance in volume resuscitation, oxygenation and ventilation is critical.
In this EM Cases CritCases blog - a collaboration with STARS Air Ambulance Service, Mike Betzner, we present a challenging airway obstruction case, the limitations of non-rebreather masks, using PEEP on bag-valve-masks, heliox, tips on awake intubation, and the differential for high peak inspiratory pressures in the post intubation period. With commentary by Michael Betzner and Reuben Strayer as well as expert peer review by George Kovacs...
In this CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, Dr. Michael Misch discusses the management controversies around a challenging pediatric drowning and hypothermia case, including the nuances of rewarming, oxygenation, CPR or no CPR, the role of ECMO, dosing of epinephrine and more...
In this CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, Dr. James Brokenshire presents a case of acute unstable Uterine Inversion and discusses key therapeutic maneuvers including the Johnson Maneuver, tocolytics and resuscitation of postpartum hemorrhage.
EM Cases CritCases 3 - GSW to the chest in a rural setting. In this CritCases we discuss preparation for penetrating trauma in a rural setting, the ABC score, massive transfusion protocol, clamshell thoracotomy, trauma intubation and more. The Case... You are the transport physician on call. A 50-year old male with a history of depression allegedly shot himself in the chest with a rifle. A bystander called 911. The local paramedics are en route and the air transport team is activated with a plan to rendezvous at the nearest hospital, Janus General, which is 90 minutes by ground from the nearest tertiary care centre. You contact the rural hospital for a status update but all they can tell you is that his GCS is 14 and he has a GSW to the central chest.
Welcome to EM Cases' CritCases blog, a collaboration between Mike Betzner, the STARS air ambulance service and EM Cases’ Michael Misch and Anton Helman! These are educational cases with multiple decision points where there is no strong evidence to guide us. Various strategies and opinions from providers around the world are coalesced and presented to you in an engaging format. Enjoy!