Over the past decade, the annual hours of critical care delivered in US emergency departments has sharply risen. Undoubtedly, many critically ill patients remain in the ED for numerous hours awaiting an ICU bed.  In an attempt to improve the delivery of critical care to boarding ED patients, several hospitals and health care systems have recently implemented ED-based ICUs.  In this podcast, …

Over 500,000 patients suffer sudden cardiac arrest each year in the United States.  Though survival rates are improving, there remains significant variation in outcomes by region.  In recent years, numerous advances in post-resuscitation care have been associated with improved outcomes.  In this podcast, we discuss the key elements of post-arrest care along with current controversies. Most importantly, we discuss what you NEED to …

The World’s population is aging. By 2030, 20 percent of the US population will be over the age of 65 years.  Older patients have a number of age-related physiologic changes that impact their disease presentation and resuscitation.  In this podcast, we review common physiologic changes in the geriatric patient and provide critical resuscitation pearls when confronted with the sick, geriatric patient.

With increasing water temperatures, there is a rise in the incidence of V.vulnificus infections in non-endemic regions.  Patients with V.vulnificus infection are often critically ill, can quickly decompensate, and crash within hours.  In this podcast, we discuss the clinical characteristics of this serious infection, along with the current treatments of choice. A very hot and timely topic!

ICH accounts for approximately 15 percent of all strokes.  Despite improvements in neurocritical care, the mortality for patients with ICH can still reach 50 percent at 1-year, with many left with significant residual deficits.  Patients with an ICH who are taking an oral anticoagulant medication tend to have larger ICH volumes, more frequent IVH, and a greater frequency of hematoma expansion.  In this …

A critical component to post-arrest care for the patient with ROSC following out-of-hospital cardiac arrest is early coronary angiography. Current guidelines recommend immediate cardiac angiography for patients with evidence of a STEMI on their post-arrest ECG. For the more common scenario of non-diagnostic ECGs, the role of early coronary angiography remains uncertain. In this podcast, superstar Amal Mattu joins us …

Emergency medicine, critical care, and acute care providers evaluate, resuscitate, and manage patients with shock on a daily basis.  Despite initial efforts, a select number of patients are refractory to fluid and vasopressor administration.  In this podcast, we discuss a rationale approach to vasopressor administration, along with several rescue therapies for the patient with refractory vasodilatory shock.

Renal transplants are one of the most common organ transplants worldwide.  Renal transplant patients can quickly succumb to illness and present to the ED or be admitted to the ICU in need of urgent resuscitation.  In this podcast, we discuss critical pearls and pitfalls in managing the renal transplant patient.

Rory Spiegel (@EMNerd_) joins the podcast this month for an in-depth analysis and discussion of the recently published ANDROMEDA-SHOCK trial.  Should capillary refill time replace serial lactate values for guiding the hemodynamic resuscitation of patients with septic shock? What are the limitations of this potential game-changing study? How will you incorporate its results into your clinical practice?