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?

More than 1.5 million patients undergo endotracheal intubation each year in the U.S.  Endotracheal intubation can be complicated by hypoxemia, which is a known risk factor for peri-intubation cardiac arrest and death.  Rapid sequence intubation typically involves a delay of up to 2 minutes between the administration of sedative/paralytic medications and laryngoscopy.  In this podcast, we discuss a recent article in the New …

Respiratory distress in the patient with a tracheostomy can incite fear in even the most seasoned emergency physician or intensivist.  In this episode, we review the initial management of respiratory distress in the trach patient, along with a review of common tracheostomy emergencies that are likely to present to your ED or ICU.

As bitter cold temperatures grip the Northeast, many struggle to stay warm and often resort to nontraditional methods of heating.  As a result, there has been an increase in the number of cases of CO toxicity.  In this episode, we cover what you NEED to know about diagnosing and managing the critically ill patient with CO exposure.

As EDs across the country strive to meet sepsis benchmark metrics, many have implemented a variety of screening tools. With the publication of Sepsis-3, qSOFA is the latest screening tool recommended for patients outside of the ICU setting. In this podcast we review the derivation of qSOFA and discuss recent literature on whether qSOFA is any better than traditional screening tools.

Extracorporeal life support (ECLS) is being used with increasing frequency in many EDs across the US and across the World. In this podcast, we review the basics of ECLS, as well as discuss the current indications, contraindications, and complications of this critical therapy. In addition, we review some key pearls and pitfalls in the cannulation of patients for ECLS.

A plethora of great articles pertaining to the care of critically ill patients were published in 2018. In this podcast, we review some of the key articles you NEED to know from the 2018 emergency medicine and critical care literature.