Critically ill patients with acute hypoxic respiratory failure receive supplemental oxygen as a component of their treatment.  In recent years, exposure to high levels of FiO2 with resultant “hyperoxia” have been associated with increased mortality in critically ill patients.  At present, there is no clinical practice guideline on oxygenation targets for adult patients with hypoxic respiratory failure.  In this podcast, we discuss the …
The Critically Ill Patient with Aortic Stenosis
Patients with severe aortic stenosis who present with acute decompensated heart failure are among the most challenging patients to resuscitate. In this podcast, we discuss the pearls and pitfalls in managing both the hypertensive and hypotensive patient with severe AS and acute heart failure.
2020 – A Year in Review
To say that 2020 has been a challenging year would be a gross understatement.  The courage and determination that all healthcare providers have shown in confronting the COVID-19 pandemic has been nothing short of inspirational.  In addition to the thousands of COVID-19 patients, we have also needed to manage many other critical illness conditions that have presented to our various settings.  In this annual …
2020 AHA Updates: Post-Arrest Care
The period following ROSC from cardiac arrest is a time when lives can be saved…or lost. A systematic and comprehensive approach to post-arrest care is associated with improved survival to discharge with good neurologic function. In this podcast, we discuss the recently published 2020 AHA Updates to Cardiopulmonary Resuscitation and Emergency Cardiovascular Care with attention to Post-Arrest care.
2020 AHA Guidelines for Cardiopulmonary Resuscitation
Approximately 350,000 adults in the US experience an out-of-hospital cardiac arrest (OHCA).  Despite numerous potential improvements in treatments, survival from OHCA remains essentially unchanged since 2012. The American Heart Association (AHA) just released its 2020 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.  In this podcast, we review the key updates and recommendations that impact the acute care provider managing the patient …
Electrical Storm
Although electrical storm is an uncommon presentation, it is important that we readily recognize and treat these patients to prevent rapid progression to cardiac arrest. Effective management can be complex. In this podcast we discuss the management of patients with unstable and stable electrical storm.
Acute Liver Failure
Patients with acute liver failure can be incredibly sick and have an exceedingly high mortality.  Early identification and prompt, evidence-based management of the patient with acute liver failure may improve patient-centered outcomes.  In this podcast, we discuss updated guidelines for the management of adult patients with acute liver failure. Key resuscitation topics include fluid resuscitation, blood pressure targets, vasopressor selection, bleeding and …
Ketamine in the Critically Ill
Ketamine is a well-known anesthetic used commonly in the ED for RSI and procedural sedation. In this podcast, we review the use of ketamine in other critical illness states, such as status asthmaticus, status epilepticus, acute pain management, and acute alcohol withdrawal syndrome.
The Critically Ill ED Boarder
Emergency department (ED) visits for critically ill patients has nearly doubled over the past decade. Unfortunately, ED boarding of critically ill patients awaiting ICU admission has also risen significantly, and is associated with several adverse patient outcomes. In this podcast, we review a white paper on boarding of the critically ill ED patient just published in Critical Care Medicine by …
TXA for GI Bleeds? The HALT-IT Trial
The use of tranexamic acid (TXA) has markedly increased since the results of the CRASH-II trial were published.  In addition to its use in trauma, TXA has been evaluated and used in numerous other conditions, including post-partum hemorrhage and epistaxis.  Recently, the HALT-IT Trial was published online in the Lancet, which evaluated the use of TXA in patients with acute gastrointestinal bleeding.  In …