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Mashup Score: 111Right heart catheterization (RHC) - 2 month(s) ago
CONTENTS Rapid reference 🚀 Normal values When to insert: Contraindications to RHC Indications for RHC Insertion technique Waveforms Whip artifact Under-damping Over-damping Atrial fibrillation Tricuspid regurgitation RV failure Tamponade CVP (central venous pressure) Wedge pressure Avoid unnecessary wedge measurements Under-wedging Over-wedging Zone 3 placement Wedge-PA diastolic relationship When wedge inaccurately reflects preload Cardiac output Thermodilution […]
Source: emcrit.orgCategories: General Medicine News, Critical CareTweet
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Mashup Score: 243PulmCrit- Epinephrine vs. atropine for bradycardic periarrest - 2 month(s) ago
Introduction with a case An elderly woman is admitted with atrial fibrillation and fast ventricular rate. She is asymptomatic, with a heart rate of 160
Source: emcrit.orgCategories: General Medicine News, Critical CareTweet-
for patients who are legit trying to die from bradycardia, I advocate using epinephrine 1st epinephrine is more reliably effective & honestly just a better anti-death medication I've seen patients arrest while folks were messing around w/ atropine more: https://t.co/mTdFs2TzwI https://t.co/IAYnx9WdP3
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Mashup Score: 164Fluid selection & pH-guided fluid resuscitation - 2 month(s) ago
CONTENTS Rapid Reference 🚀 Forward Crystalloids vs. colloids Step I: Balanced Crystalloid Choice of balanced crystalloid Step II: pH-guided resuscitation Hypertonic & isotonic bicarbonate Therapeutic alkalinization to augment permissive hypercapnia Formulation of enteral resuscitation fluid Podcast Questions & discussion Pitfalls The illustration above may appear a bit amusing, but this actually mirrors various practices that […]
Source: emcrit.orgCategories: General Medicine News, Critical CareTweet-
How to create oral resuscitation fluid at the bedside using soy sauce packets: 🍣 replicate normal saline or a balanced crystalloid (alkali not included though) 🍣 easy, fast, cheap 🍣 conserve IV fluid in situations where it’s safe to do so https://t.co/K3Qfls0lqw https://t.co/WWeiCILOdA
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Mashup Score: 100Alcohol withdrawal - 3 month(s) ago
CONTENTS Rapid Reference 🚀 Preamble & disclaimer Diagnosis Alcohol withdrawal vs. hepatic encephalopathy Therapeutic target (CIWA vs RASS) Treatment: Phenobarbital monotherapy Phenobarbital pharmacology Advantages of phenobarbital over benzodiazepines Contraindications to phenobarbital ➡️ Phenobarbital guideline Checking phenobarbital levels? ➡️ Pitfalls of phenobarbital Alternative agents Benzodiazepines Valproic acid Antipsychotics & alpha-2 agonists (dexmedetomidine, clonidine, guanfacine) Ketamine Other […]
Source: emcrit.orgCategories: General Medicine News, Critical CareTweet-
👇💯 agree (its wrong) PB has a wide therapeutic window 15-25 ug/ml is usually fine to treat EtOH w/d coma doesn't usually occur until >65 ug/mL this window is why PB monotx is safer than benzodiazepines (which lack reproducible pharmacokinetics) https://t.co/4DXNOL0Bz5 https://t.co/SGrjnvIzli https://t.co/RgIiDUIn7X
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Mashup Score: 224The fallacy of time-to-intervention studies - 3 month(s) ago
0 Time and tide wait for no intervention – Geoffrey Chaucer 0 We are barraged by time-to-intervention studies
Source: emcrit.orgCategories: General Medicine News, Critical CareTweet-
hard cosign. I explained why this study is incorrect over a *decade* ago! https://t.co/nLWrTeAo53 if you actually believe that giving antibiotics an hour earlier reduces mortality by 8%, please DM me about some oceanside properties in vermont to invest in. https://t.co/nHX5g72W4B
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Mashup Score: 211The fallacy of time-to-intervention studies - 3 month(s) ago
0 Time and tide wait for no intervention – Geoffrey Chaucer 0 We are barraged by time-to-intervention studies
Source: emcrit.orgCategories: General Medicine News, Critical CareTweet-
hard cosign. I explained why this study is incorrect over a *decade* ago! https://t.co/nLWrTeAo53 if you actually believe that giving antibiotics an hour earlier reduces mortality by 8%, please DM me about some oceanside properties in vermont to invest in. https://t.co/nHX5g72W4B
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Mashup Score: 211The fallacy of time-to-intervention studies - 3 month(s) ago
0 Time and tide wait for no intervention – Geoffrey Chaucer 0 We are barraged by time-to-intervention studies
Source: emcrit.orgCategories: General Medicine News, Critical CareTweet-
hard cosign. I explained why this study is incorrect over a *decade* ago! https://t.co/nLWrTeAo53 if you actually believe that giving antibiotics an hour earlier reduces mortality by 8%, please DM me about some oceanside properties in vermont to invest in. https://t.co/nHX5g72W4B
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Mashup Score: 105Pneumocystis Jiroveci Pneumonia (PJP) - 4 month(s) ago
CONTENTS Background: HIV(-)PJP vs. HIV(+)PJP Epidemiology Clinical presentation Radiology Chest radiograph Chest CT scan Blood tests Serum beta-D-glucan ➡️ Other labs (LDH, CRP, PCT) Microbiology tests Bronchoscopy Non-bronchoscopic sampling Approach to diagnosis Early invasive approach Early noninvasive approach Treatment Antibiotics Steroid Prognosis Podcast Questions & discussion Pitfalls PJP (previously known as Pneumocystis Carinii Pneumonia) presents […]
Source: emcrit.orgCategories: General Medicine News, Critical CareTweet-
Recently updated the pneumocystis pneumonia chapter, here are my top three pearls from the PJP literature 🤓 🧵#1/4… (chapter: https://t.co/g59KfWJZcD) https://t.co/7XZls889Qh
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Mashup Score: 167Acute exacerbation of COPD (AECOPD) - 4 month(s) ago
CONTENTS Rapid Reference 🚀 Evaluation Common differential diagnostic challenges in AECOPD Pneumonia PE Heart failure Upper airway obstruction Acute exacerbation of OHS Sedating medications Asthma Bronchiectasis Basic treatments Noninvasive ventilatory strategies BiPAP is the first line Difficulty tolerating BiPAP HFNC Monitoring on HFNC/BiPAP Indications for delayed intubation How long should BiPAP/HFNC be continued? Intubation and […]
Source: emcrit.orgCategories: General Medicine News, Critical CareTweet-
this is largely incorrect MANY pts meeting these criteria would respond well to BiPAP & avoid intubation often depends on trajectory & serial evaluation any cookie-cutter approach with specific ABG cutoffs is arbitrary & amateurish explored in IBCC https://t.co/bQemphzf4h https://t.co/vPKmqDsNPg
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Mashup Score: 51Mold infections (aspergillosis, mucormycosis) - 4 month(s) ago
CONTENTS Invasive pulmonary aspergillosis: Overall approach to the diagnosis 🚀 Presentation Investigations Radiology Galactomannan ➡️ Beta-D-Glucan ➡️ Culture & fungal stain Bronchoscopy Tissue diagnosis Treatment Other forms of Aspergillus infection: Aspergillus tracheobronchitis Aspergilloma Chronic cavitary pulmonary aspergillosis Other mold infections: Invasive pulmonary mucormycosis Related topics PCR for invasive pulmonary aspergillosis Podcast Questions & discussion Pitfalls […]
Source: emcrit.orgCategories: General Medicine News, Critical CareTweet-
updated the chapter on invasive aspergillus, here are some highlights. diagnosis starts with the tests below PCR is more widely available in Europe. given frequent colonization, qualitative PCR might not help much (more tests= more confusion) (chapter: https://t.co/xgcVg6k2TE) https://t.co/j27ZzuTgUt
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direct Fick for intubated patients with a PA catheter: volumetric capnography *measures* the patient's VCO2 VO2 ~ (1.25*VCO2) don't think this has been published yet but it makes sense (someone out there - pls show its better than indirect Fick) more: https://t.co/uhkx0cElv3 https://t.co/sBZzF3RacX