Should We Administer Steroids in Severe CAP?

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In recent years,  numerous trials have investigated the administration of corticosteroids in patients with pneumonia and have produced mixed results.  In this podcast, we discuss the latest randomized trial, the CAPE COD trial, that evaluated whether the administration of hydrocortisone to ICU patients with severe CAP reduced mortality.  Is this a therapy we should look to administer in the ED …

ECPR for OHCA? – The INCEPTION Trial

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In recent years, several single center trials have demonstrated positive outcomes in patients with OHCA randomized to receive ECPR compared with patients who received standard resuscitation.  Not surprisingly, these single center studies have limitations that impact the generalizability of these results.  In the current podcast, we discuss the recently published INCEPTION Trial, which is a multicenter, randomized trial that compared the effect …

Should We Use a Liberal or Restrictive Fluid Strategy in Sepsis – The CLOVERS Trial

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Intravenous fluid (IVF) administration is a central tenet to the resuscitation of patients with sepsis and sepsis-induced hypotension.  At present, the administration of large volumes of IVF is common, though based on low quality of evidence.  In this podcast, we review and interpret the recently published CLOVERS Trial, which compared the use of a liberal fluid strategy with a restrictive …

Top Critical Care Articles of 2022

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Given the increase in critically ill patients who present to the ED in need of resuscitation, along with the increase in those who board in the ED awaiting an ICU bed, it is imperative that the emergency physician be knowledgeable about recent literature in resuscitation and critical care medicine. In this podcast, we discuss important articles published in 2022 that …

Double Sequential External Defibrillation for Refractory Ventricular Fibrillation

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More than 350,000 cardiac arrests occur each year in North America.  Approximately 100,000 of these arrests are due to shockable rhythms.  Unfortunately, many patients have refractory ventricular fibrillation and do not respond to many attempts at standard defibrillation.  In this podcast, we discuss a recent study that evaluated double sequential external defibrillation and vector-change defibrillation compared to standard defibrillation in …

Does the Timing of Source Control in Sepsis Make a Difference?

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The emergency department resuscitation of patients with sepsis focuses on early recognition, timely administration of appropriate antibiotics, appropriate fluid resuscitation, early vasopressor initiation for patients with sepsis-induced hypoperfusion, and hemodynamic monitoring.  Source control is also an important component in the resuscitation of patients with sepsis.  Though current guidelines identify source control as a “best practice” the optimal timing of source control remains …

Does a Restrictive Oxygenation Target Make a Difference in the Post-Arrest Patient?

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The care of patients with return of spontaneous circulation following cardiac arrest centers on optimizing oxygenation and ventilation, optimizing hemodynamics, identifying patients that require immediate coronary angiography, detecting seizures, and targeted temperature management.  In recent years, numerous articles have evaluated various components of this post-arrest bundle of care.  In the current podcast, we discuss Part II of the BOX Trial that evaluated …

Does a Higher MAP in the Post-Arrest Patient Make a Difference?

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The care of patients with return of spontaneous circulation following cardiac arrest centers on optimizing oxygenation and ventilation, optimizing hemodynamics, identifying patients that require immediate coronary angiography, detecting seizures, and targeted temperature management.  In recent years, numerous articles have evaluated various components of this post-arrest bundle of care.  In the current podcast, we discuss Part I of the BOX Trial that evaluated …

IVFs to Prevent Cardiovascular Collapse During RSI – The PREPARE II Trial

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Approximately 2 million adult patients undergo intubation in the United States each year.  Hypotension and cardiovascular collapse may occur in up to 40% of critically ill patients in the ICU who undergo intubation.  Guidelines and expert recommendations often suggest the administration of IVFs during RSI to prevent cardiovascular collapse.  However, a recent trial found that an IVF bolus during induction …

TAVR Complications You Need to Know!

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Transcatheter aortic valve replacement is now more common than open surgical replacement and may be associated with lower mortality.  Given the significant increase in TAVRs it is imperative to be knowledgeable on the complications that may occur following TAVR and result in patients presenting to acute care settings for evaluation and treatment.  In this podcast we review an outstanding recent …