Top Critical Care Articles of 2022

ccpempod

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

ccpempod

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 …

What is the Optimal SpO2 Target in Vented Patients?

ccpempod

Approximately 3 million critically ill patients are intubated and initiated on mechanical ventilation each year in the United States. A critical component of mechanical ventilation is the adjustment of FiO2 to maintain adequate arterial oxygen saturation.  However, the optimal oxygenation target in critically ill adult patients receiving mechanical ventilation remains uncertain. In this podcast we discuss a recently published study, the …

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

ccpempod

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?

ccpempod

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?

ccpempod

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

ccpempod

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!

ccpempod

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 …

Restrictive Fluid Resuscitation in Sepsis? The CLASSIC Trial

ccpempod

IVF administration is central to the management of patients with sepsis.  Though the Surviving Sepsis Campaign recently downgraded its recommendation on the amount of initial fluid administration, there are currently no recommendations on a fluid strategy for septic patients who continue to demonstrate hypoperfusion after the initial fluid bolus.  In this podcast we discuss the recently published CLASSIC Trial, which …

Life-Threatening Asthma

ccpempod

Approximately 2 million patients present each year to EDs in the United States for acute asthma exacerbations.  Of these, up to 50,000 may require ICU admission for continued care and resuscitation.  The management of critically ill asthmatic patients can be fraught with peril.  In this podcast we discuss the assessment and management of patients presenting with a severe asthma exacerbation.