While COVID continued to be predominant in 2021, a number of important articles that pertained to various aspects of critical care and resuscitation were published. In this podcast, we review a few important trials that were published in 2021 and their impact upon the management of select critical illnesses.
EM-STAT!
Resuscitating the sick patient and providing ongoing critical care is incredibly challenging in critical access locations and resource limited EDs. In this podcast, we interview Dr. Eric Klotz who has runs a hugely successful mobile critical care team that provides ongoing critical care and resuscitation to patients requiring transfer from resource limited settings.
Bicarbonate Therapy in the Critically Ill Patient
In this podcast we are joined by EM/CCM superstars Dr. Gabe Wardi and Dr. Kit Tainter, who discuss the physiologic effects of metabolic acidosis, the rationale for sodium bicarbonate administration, and its use in select critical illness states. An awesome podcast to start of 2022!
The BOUGIE Trial
More than 1.5 million patients are intubated each year in the United States. In up to 20% of patients, the first attempt at intubation is not successful and places patients at risk for peri-intubation cardiovascular collapse and death. In recent years, many providers have used the bougie as either a rescue device for failed attempts or during the initial attempt at intubation. In …
MIS-C in COVID-19
The COVID-19 pandemic continues to affect millions of patients worldwide.  While the majority of children have milder illness compared with adults, some develop multisystem inflammatory syndrome with a significant increase in morbidity and mortality.  In this podcast, we discuss a recent review article on MIS-C as it pertains to the pediatric patient with COVID-19.
Hyperkalemia in the ED
Hyperkalemia is a life-threatening electrolyte disorder that is commonly encountered in the ED and ICU. In this podcast we review the latest evidence in the management of hyperkalemia based on a recently published consensus-based panel. https://ccpem.blog/wp-content/uploads/2021/11/CCPEM-Hyperkalemia-in-the-Emergency-Department.pdf
Vasopressin and Steroids for IHCA?
In 2009 and 2013 investigators published studies that demonstrated improved outcomes in patients with IHCA who received vasopressin and steroids in addition to epinephrine. However, both US and European cardiac arrest guidelines have not endorsed these medications due to lack of additional evidence. In this podcast we discuss the recently published VAM-IHCA trial, which evaluated vasopressin and steroids for patients …
Milrinone or Dobutamine for Cardiogenic Shock?
Hemodynamic management of patients with cardiogenic shock centers on vasopressors, inotropes, and mechanical circulatory devices. With respect to inotropic medications, there is little data to guide optimal management and selection of agents. In this podcast we discuss the results of a recent trial that compared milrinone with dobutamine for patients with cardiogenic shock. Which agent was the winner?
The TOMAHAWK Study
The COACT trial demonstrated no improvement in 90-day mortality for post-arrest patients without evidence of an ST-segment elevation MI who were randomized to immediate or delayed coronary angiography. However, the COACT Trial included only OHCA with a shockable rhythm and overall had a very low number of patients that had an acute thrombus at the time of angiography. In this …
The BaSICS Trial – Implications for Fluid Resuscitation
The administration of IVFs is nearly universal in critically ill patients. In recent years, several studies have suggested improved outcomes with the use of balanced crystalloids solutions in contrast to 0.9% NS. In this podcast, we discuss the recently published BaSICS Trial that evaluated Plasma-Lyte 148 with 0.9% NS in critically ill patients. Does this study provide practice-changing evidence to …