There has been an explosion of literature on the evaluation and management of patients with COVID-19 infection. In this podcast, we discuss updates (as of June 2020) in the care of critically ill patients with COVID-19. We touch on non-invasive ventilation, mechanical ventilation, proning, and medication administration.
Diastolic Shock Index
Emergency medicine, critical care, and resuscitationists often use the Shock Index to identify patients with increased mortality. The Shock Index is calculated by dividing heart rate by the systolic blood pressure, with a value > 0.8 identifying a potential critically ill patient. In the setting of sepsis, the use of systolic blood pressure to calculate the Shock Index may be …
HFNC in COVID-19 Patients – Helpful or Harmful?
As we gain more experience managing critically ill patients with COVID-19 infection there has been a shift away from immediate intubation and towards more frequent use of non-invasive ventilatory strategies. Dr. Michael Allison joins CCPEM this podcast to discuss the latest evidence, controversies, and recommendations on the use of HFNC in COVID-19 patients. Play episode here!
COVID-19: Toxicities of Potential Therapies
Currently, there is no approved treatment or proven therapy for COVID-19. As such, many have turned to treatments with little to no supporting evidence. In this podcast, we bring back EM Pharmacy extraordinaire Bryan Hayes to discuss information on the toxicities of potential therapies used in the management of patients with COVID-19.
Vasopressors & The Older Patient – The 65 Trial
Current guidelines for many critical illnesses recommend targeting a MAP of 65 mm Hg, with consideration of higher MAPs in older patients with chronic HTN. Recent literature, however, suggests increased mortality in older patients who are exposed to larger quantities of vasopressor medications. In this podcast, we do a deep dive into the recently published 65 Trial, which sought to …
Critical Care Management COVID-19 Update – March 30, 2020
Our understanding and management of patients with COVID-19 infection continues to rapidly evolve, almost on a daily basis. In this podcast, we discuss current experience and thoughts on managing the critically ill patient with COVID-19 infection with attention to ventilator management.
Vitamin C for Septic Shock?
In 2017, Paul Marik published a single-center retrospective before-and-after study that demonstrated significant mortality benefit to patients with septic shock who received a cocktail of steroids, vitamin C, and hydrocortisone. Since that time, many providers have adopted this cocktail for the treatment of septic shock, despite the fact that no randomized trial has evaluated this regimen. In this podcast, we …
COVID-19 Update – March 2020
In December 2019 a novel coronavirus (now named COVID-19) was identified as responsible for a cluster of pneumonia cases in Wuhan, China. As of March 2020, over 50 countries have identified patients who have tested (+) for COVID-19, with over 90,000 identified cases and more than 3000 deaths to date. As the discussion regarding COVID-19 rapidly evolves, it is important …
Roc vs. Sux – The CURASMUR Trial
The debate on the ideal neuromuscular blocking agent for RSI in emergency intubations rages on. In this podcast, we review the latest randomized trial comparing rocuronium with succinylcholine in out-of-hospital patients needing emergency tracheal intubation – The CURASMUR Trial. Emergency medicine airway guru Dr. Ken Butler takes us through the paper and provides his expert opinion on which NMBA you should be …
Identifying and Treating EVALI
In recent years, the use of e-cigarette and vaping products has sharply risen. Concomitant with the increased use is an increase in patients presenting with severe respiratory disease associated with these products. In this podcast we review the latest information on the clinical presentation, diagnosis, and treatment of patients presenting with e-cigarette associated acute lung injury (EVALI).