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.
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 evaluate the effect of permissive hypotension in older patients with vasodilatory hypotension.
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.
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 welcome EM/CCM superstar Dr. Gabriel Wardi to review the VITAMINS trial, a randomized clinical trial evaluating this cocktail among patients with septic shock.
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 for clinicians to prepare locally and to review standards for prevention, diagnosis, and treatment. In this podcast, we review the latest information on identification, diagnosis, and treatment of patients with COVID-19 infection.
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 reaching for in your next intubation!
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).
The number of critically ill cancer patients presenting to the ED is increasing. Though many of these patients are critically ill with conditions directly related to their cancer, some are sick as a result of toxicities from new therapies used to treat their cancer. Dr. Sarah Dubbs joins the podcast to discuss what we NEED to know about these new classes of cancer therapies and their related toxicities. Simply a TON of pearls in this 25-minute podcast.
A plethora of literature was published during the course of 2019. In this podcast, we review several key articles published in the 2019 critical care literature that pertain to the resuscitation and management of select critically ill patients. Simply a great way to start 2020!
Up to one-third of patients with status epilepticus will not respond to benzodiazepines. Unfortunately, treatment of benzodiazepine-refractory status epilepticus is not well studied. The longer seizures persist, the worse patients do. In this podcast, we discuss the results of the recently completed ESETT trial that evaluated three anticonvulsant medications for status epilepticus.