Resuscitation
CritCases 9 Pre-Eclampsia and Preterm Labor – Time Sensitive Management
In this CritCases blog we present a case of a 30 week gestational age pregnant woman with high blood pressure, headache, blurry vision and pelvic cramping. We discuss the management challenges of transporting a patient with severe pre-eclampsia and preterm labor, with special attention to dosing of magnesium, antihypertensive agents choice, and indications for steroids, tocolytics and antibiotics.
Ep 104 Emergency Management of Intracerebral Hemorrhage – The Golden Hour
There exists a kind of self-fulfilling prognostic pessimism when it comes to ICH. And this pessimism sometimes leads to less than optimal care in patients who otherwise might have had a reasonably good outcome if they were managed aggressively. Despite the poor prognosis of these patients overall, there is some evidence to suggest that early aggressive medical management may improve outcomes. As such, the skill with which you manage your patient with ICH in those first few hours could be the most important determinant of their outcome. In this Golden Hour you have a chance to prevent hematoma expansion, stabilize intracerebral perfusion and give your patient the best chance of survival with neurologic recovery.
Episode 102 GI Bleed Emergencies Part 2
In Part 2 of our two part podcast on GI Bleed Emergencies Anand Swaminathan and Salim Rezaie kick off with a discussion on the evidence for benefit of various medications in ED patients with upper GI bleed. PPIs, somatostatin analogues such as Octreotide, antibiotic prophylaxis and prokinetics have varying degrees of benefit, and we should know which ones to prioritize. We then discuss the usefulness of the Glasgow-Blatchford and Rockall scores for risk stratification and disposition of patient with upper GI bleeds and hit it home with putting it all together in a practical algorithm. Enjoy!
Episode 101 GI Bleed Emergencies Part 1
In this Part 1 of our two part podcast on GI bleed emergencies we answer questions such as: How do you distinguish between an upper vs lower GI bleed when it's not so obvious clinically? What alterations to airway management are necessary for the GI bleed patient? What do we need to know about the value of fecal occult blood in determining whether or not a patient has a GI bleed? Which patients require red cell transfusions? Massive transfusion? Why is it important to get a fibrinogen level in the sick GI bleed patient? What are the goals of resuscitation in a massive GI bleed? What's the evidence for using an NG tube for diagnosis and management of upper GI bleeds? In which patients should we give tranexamic acid and which patients should we avoid it in? How are the indications for massive transfusion in GI bleed different to the trauma patient? What are your options if the bleeding can't be stopped on endoscopy? and many more...
CritCases 8 Management of Elevated ICP
In this CritCases blog - a collaboration between STARS Air Ambulance Service, Mike Betzner and EM Cases, we take you through a not uncommon stroke presentation which then develops into a challenge with regard to management of elevated ICP, hypertension and the airway...
Best Case Ever 60 What we can learn from Prehospital Trauma Management
In this EM Cases podcast Dr. Joel Lockwood tells his Best Case Ever of a prehospital trauma resuscitation, bringing to light the challenges faced by EMS with the complicated trauma patient. He discusses the importance of checklists, practice and simulation to help streamline the process, offloading some cognitive burden, prepare the team, reduce the change of errors, improve efficiency and etch actions into each team member's muscle memory.