CCPEM Podcast Episodes

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 podcast, we review the latest recommendations on reversing anticoagulant medications in patients with an ICH. This is information you can’t afford to miss!

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 to discuss an article just published in the New England Journal of Medicine on early coronary angiography for patients without evidence of STEMI following ROSC.

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 England Journal of Medicine that suggests critically ill patients may benefit from bag-mask ventilation during the period between medication administration and laryngoscopy. 

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.