Tag Archive

Central venous catheter (CVC) placement is common in critically ill patients for a variety of indications.  Thrombocytopenia is also quite common in critically ill patients.  Unfortunately, literature and guideline recommendations vary on the threshold for prophylactic platelet transfusion in patients undergoing a procedure.  In this podcast we discuss a recent trial that evaluated prophylactic platelet transfusion in patients with severe …

Over 1 million critically ill patients undergo intubation each year in the United States.  Though direct laryngoscopy remains the most common technique worldwide for intubation, the use of video laryngoscopy has significantly increased.  Studies evaluating video to direct laryngoscopy have thus far produced mixed results.  In this podcast, we review the latest randomized trial, the DEVICE Trial, that assessed video with …

Both etomidate and propofol are commonly used sedative agents in critically ill patients.  Recent literature has suggested that these agents may result in increased harm and mortality.  In this podcast, we discuss the most recent two systematic reviews and meta-analyses that evaluated etomidate and propofol in critically ill patients.  Do we need to change our practice?

In recent years,  numerous trials have investigated the administration of corticosteroids in patients with pneumonia and have produced mixed results.  In this podcast, we discuss the latest randomized trial, the CAPE COD trial, that evaluated whether the administration of hydrocortisone to ICU patients with severe CAP reduced mortality.  Is this a therapy we should look to administer in the ED …

In recent years, several single center trials have demonstrated positive outcomes in patients with OHCA randomized to receive ECPR compared with patients who received standard resuscitation.  Not surprisingly, these single center studies have limitations that impact the generalizability of these results.  In the current podcast, we discuss the recently published INCEPTION Trial, which is a multicenter, randomized trial that compared the effect …

Intravenous fluid (IVF) administration is a central tenet to the resuscitation of patients with sepsis and sepsis-induced hypotension.  At present, the administration of large volumes of IVF is common, though based on low quality of evidence.  In this podcast, we review and interpret the recently published CLOVERS Trial, which compared the use of a liberal fluid strategy with a restrictive …

Given the increase in critically ill patients who present to the ED in need of resuscitation, along with the increase in those who board in the ED awaiting an ICU bed, it is imperative that the emergency physician be knowledgeable about recent literature in resuscitation and critical care medicine. In this podcast, we discuss important articles published in 2022 that …

More than 350,000 cardiac arrests occur each year in North America.  Approximately 100,000 of these arrests are due to shockable rhythms.  Unfortunately, many patients have refractory ventricular fibrillation and do not respond to many attempts at standard defibrillation.  In this podcast, we discuss a recent study that evaluated double sequential external defibrillation and vector-change defibrillation compared to standard defibrillation in …

The emergency department resuscitation of patients with sepsis focuses on early recognition, timely administration of appropriate antibiotics, appropriate fluid resuscitation, early vasopressor initiation for patients with sepsis-induced hypoperfusion, and hemodynamic monitoring.  Source control is also an important component in the resuscitation of patients with sepsis.  Though current guidelines identify source control as a “best practice” the optimal timing of source control remains …

The care of patients with return of spontaneous circulation following cardiac arrest centers on optimizing oxygenation and ventilation, optimizing hemodynamics, identifying patients that require immediate coronary angiography, detecting seizures, and targeted temperature management.  In recent years, numerous articles have evaluated various components of this post-arrest bundle of care.  In the current podcast, we discuss Part II of the BOX Trial that evaluated …