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EMCrit Podcast - Critical Care and Resuscitation

Scott D. Weingart, MD FCCM

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661
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EMCrit Podcast - Critical Care and Resuscitation

EMCrit Podcast - Critical Care and Resuscitation

Scott D. Weingart, MD FCCM

70
Followers
661
Plays
OVERVIEWEPISODESYOU MAY ALSO LIKE

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About Us

Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation

Latest Episodes

EMCrit 279 – The Decision to use Ketamine – Disruptive and Dangerous with Reub Strayer

EI frequently see both residents and attendings inappropriately using ketamine for agitated patients. Inappropriately both by giving it when it is unecessary and giving it in poor fashion when it is indicated. Our guest today is Reub Strayer (@emupdates). He is the author of EMUpdates.com. His research and clinical interests include checklists and standardization, airway, legislative work on the treatment of opioid dependence, and an approach to opioid misuse in the ED. Reub breaks agitated patients down in to 3 groups: 1. Agitated, but Cooperative Not a problem in the ED. Oral medications or non-pharm techniques. 2. Disruptive without Danger Use standard anti-psychotics and sedatives, with the understanding that Haldol 5mg and Lorazepam 2 mg given IM will take a long time for full effect and even then, may not provide adequate sedation. There are better choices for this group: * Droperidol monotherapy 5-10 mg IM or 5 mg IV * Droperidol 5 mg + Midazolam 2mg IM or IV in the same syringe * Olanzapine 10 mg IM * Olanzapine 5 mg + Midazolam 2 mg IM or IV * Haldol 5 mg + Midazolam 2 mg IM or IV (will be slower than the other choices) If using standard 5/2 (haldol and lorazepam IM), too much time for effect and impatience leads to the wrong subsequent choice, i.e. giving ketamine to this group. 3. Disruptive and Dangerous * dangerous to staff, dangerous to self * danger is relative to the resources of the location Danger could be due to * The agitation itself or * An underlying condition that the agitation is preventing from being treated (and may be the cause of the agitation, e.g. tension pneumothorax) Dividing Line Question: Would you consider intubation to control the situation if ketamine was not available? Reub calls this the Ketamine Litmus Test. Ketamine takedown must be treated as Procedural Sedation (1:1 nursing observation) Intramuscular Medication Administration * Can go through clothes if you need to [Fleming et al.] * Reub states maximum volume of up to 20 mls per injection Ketamine Brain Continuum * See the EMUpdates post by Reub More on this Stuff * Podcast 060 On Human Bondage and the Art of the Chemical Takedown * Podcast 185 Disruption, Danger and Droperidol by Reub Strayer Now on to the Podcast...

23 MIN3 d ago
Comments
EMCrit 279 – The Decision to use Ketamine – Disruptive and Dangerous with Reub Strayer

EMCrit 277 – COVID Pulmonary Physiology with Martin Tobin

Today on the podcast, I interview Martin Tobin on 3 papers he has recently written on COVID pulmonary physiology. Martin Tobin * Praise for Dr. Tobin * Bio Page Caution about Early Intubation in COVID-19 p-SILI From 2 studies, 1 on sheep breathing with a human-equivalent Vt of 502 ml 2nd study was observational with a questionable connection to Vt--it was confounded by a number of other factors Absence of Obtundation L vs. H Subtypes Physio Diversion - Looking for the Patient that needs more Inspiratory Flow * Tobin Vent Review in NEJM Basing Respiratory Management of COVID-19 on Physiological Principles Tachypnea in Isolation is Not an Indication for Intubation Not indicative of increased WOB Avoiding Intubation with NIPPV Correlation of saturation with a host of other evils, but it is possible that the saturation is merely a marker--similar to pH. Vicious cycle of shunt, low SvO2, encephalopathy, decreased resp. drive. COVID has been different, with decreased saturation without the horrible lung injury that normally accompanies it. We are also used to patient discomfort from the disease causing the hypoxemia. Retained good compliance. We have not seen the isolated hypoxemia of COVID in many situations before. The Baffling Case of Silent Hypoxemia Happy Hypoxemia vs. Silent Hypoxemia Dr. Tobin defines silent hypoxemia as PaO2 < 60 mmHg with a PaCO2 >39 mmHg (as a PaCO2 < =39) blunts the dyspneic response to hypoxemia Why don't they have dyspnea vs. why do they have such severe hypoxemia unaccompanied by the degree of standard badness that normally accompanies it They do not crump They don't develop multi-organ Dyspnea Purely subjective Advanced age and diabetes may blunt dypsnea Increase in 10 of PaCO2 causes extreme air hunger Increase Ve when PaO2 <60, but severe hypoxemia elicits increase in ventilation only when PaCO2 > 39 mmHg [32539537] Definition of Hypoxemia Do we need to factor in FiO2? Dr. Tobin and I say no! I define by pulse ox or (PaO2), doesn't matter how much O2. e.g. "He is still hypoxemic despite being placed on NRB." When does Hypoxemia Become Dangerous? Pulse Ox Inaccuracy OxyHemoglobin Dissociation Curve Shifts Fever shifts to the right, Decreased CO2 shifts left Mechanism of Silent Hypoxemia ACE2 is expressed in the carotid body and may be partially to blame COVID breaks our Heuristics Heuristic representation of how bad their lung disease actually is. Projecting expected course... COVID first disease that unlinks it Now on to the Podcast...

32 MINJUL 9
Comments
EMCrit 277 – COVID Pulmonary Physiology with Martin Tobin

EMCrit 276 – The Rapid Code Status Conversation with Kei Ouchi

Today, I am joined by Kei Ouchi to disucss rapid code status discussions in Emergency Medicine and Critical Care. I came across Kei after he put up an amazing post on ALIEM with his co-author Naomi George. Conversation is the essence of palliative care--we need to be experts at them. Kei Ouchi, MD Kei Ouchi is an assistant professor of emergency medicine at the Brigham and Women's Hospital in Boston. He splits his time between EM and palliative care research. [@KeiO97] Kei's and Naomi George's Guide to Rapid Code Status Conversations More to Read * ALIEM Post * Prognosis after intubation study by Kei * Long-term prognosis after MV (Kei's new study) * Functional trajectories of older adults after critical illness * Worse than dying * How patients experience LTACH * Median survival is 8 months if older adults are transferred to LTACH How Kei Trained in Palliative Care Conversations Scott, I realized I’ve never told you anything about how I trained in palliative care communications sk...

34 MINJUN 26
Comments
EMCrit 276 – The Rapid Code Status Conversation with Kei Ouchi

EMCrit 275 – NeuroCritical Care with Neha Dangayach

Today on the podcast, we discuss Neuro-Emergencies and NeuroCritical Care with Neha Dangayach. This is a wide-ranging conversation that you will truly enjoy. Neha Dangayach Neha is joining the EMCrit team!!!!!! Neha S. Dangayach MD, MSCR is an Assistant Professor of Neurology and Neurosurgery. Dr. Dangayach serves as the Director of Neuroemergencies Management and Transfers (NEMAT) for the Mount Sinai Health System, Neurocritical Care Fellowship Director and Research Co-Director for the Institute for Critical Care Medicine (ICCM). She is also a Co-Director of the Mount Sinai Hospital’s busy NSICU and collaborates with a compassionate team to provide world-class patient-centered Neurocritical Care. She leads the Mount Sinai Critical Care Resilience Program (MSCCRP), a multidisciplinary program including intensivists, nursing, social workers, physical, occupation and speech therapists, chaplains, nutritionists among others. Several projects under this program seek to help patients an...

74 MINJUN 10
Comments
EMCrit 275 – NeuroCritical Care with Neha Dangayach

EMCrit 274 – Team Leadership with Cliff Reid

Team leadership is hard [duh]. Teaching it to our trainees is even tougher. When you work in a team of true experts with established implicit communication, things just flow--giving the the team leader the impression that they actually know what the hell they are doing. The mark of a good team leader is how they handle a less than ideal team. I found a true master to interview on the topic of team leadership--friend of the show, Cliff Reid. Attitudinal Choices * Authoritative vs. empowering * Be Aware that many of us are helped or hurt by implicit biases Gender bias paper * Ju et al. Effect of Professional Background and Gender on Residents’ Perceptions of Leadership. Academic Medicine. 2019 Nov;94:S42–7. Prep and Prebrief * Relational Coordination by Purdy et al. from Purdy et al. Where to Stand * Foot of the bed in the opinion of Cliff and me Zero Point Survey (ZPS) * Cliff's Video on ZPS * Perform STEP at the beginning then UP for team recaps Recap / SitRep / Updates-Priorities...

51 MINMAY 27
Comments
EMCrit 274 – Team Leadership with Cliff Reid

EMCrit 273 – Inhaled Pulmonary Vasodilators & Q&A with Sara Crager

This episode continues on from last time's talk by Sara Crager on Right Ventricular Failure. This is a Q&A session with a focus on inhaled pulmonary vasodilators. Nitric Oxide Sara likes it through ETT or Hi-Flo NC (can also be done through BIPAP) Start at 20 ppm See results within 5-10 minutes Monitor with CVP Additional Resources * PulmCrit- Inhaled NO for submassive PE: iNOPE or iYEP? * Review Article on Inhaled NO Epoprostenol (Flolan) May be more complicated to set-up go back to marker 5 Epoprostenol @ 0.05 mcg/kg/min Must have filters on the circuit * Review Article on Inhaled EpoProst Milrinone Get the vial, you want 1 mg/ml with 15 mls in vial 5 ml (5 mg) q 6 hours (According to Dr. Crager--may be more frequent if symptoms rebound (down to q 3 hrs)) Ideally use ultrasonic nebulizer onset ~15 minutes Must have filters on circuit LVOTO & RVOTO contraindication for the milrinone respigard!!! aeroneb pro must have filters on vent from Andre Denault Lecture Additional Resources * Inhaled Pulmonary Vasodilator Therapy for Management of Right Ventricular Dysfunction after Left Ventricular Assist Device Placement and Cardiac Transplantation * A multicentre randomized-controlled trial of inhaled milrinone in high-risk cardiac surgical patients Intratracheal Milrinone Bolus for a Crashing Patient 50-80 mcg/kg or 5 mg (1/2 a bolus is also used by some) onset 4-5 minutes from the amazing Hospitalist & the Resuscitationist Lecture 2019 by Andre Denault Nitro Need conc. of 1 mg/ml (standard bottle is 200 mcg/ml) Doses in studies range from 2.5-25 mcg/kg/min for 10 minutes or 50 ug/kg total given over 8 minutes (perhaps easiest to put 4-5 mg in neb and let it run) * PulmCrit- Nebulized nitroglycerin: The stealth pulmonary vasodilator hiding under your nose? Photo by Valeriia Bugaiova on Unsplash Now on to the Podcast...

26 MINMAY 16
Comments
EMCrit 273 – Inhaled Pulmonary Vasodilators & Q&A with Sara Crager

EMCrit 272 – Right Heart Failure with Sara Crager

We did an amazing episode on EMCrit with Susan Wilcox on Right Heart Failure. However, this oft neglected ventricle deserves even more coverage giving how pesky it can be when it fails. So we brought Sara Crager, MD to Stony Brook to give Grand Rounds. You are going to love this lecture. Part 2 is a Q&A and will be released as a separate episode. This is an embedded Microsoft Office presentation, powered by Office. Now on to the Podcast...

64 MINAPR 30
Comments
EMCrit 272 – Right Heart Failure with Sara Crager

EMCrit Wee – COVID Ventilation Round Table Discussion

Participants Josh Farkas Rory Spiegel Cameron Kyle-Sidell Scott Weingart COVID Low Low PEEP Scale not for clinical use, just a thought provoker Now on to the Wee...

22 MINAPR 25
Comments
EMCrit Wee – COVID Ventilation Round Table Discussion

EMCrit 271 – Additional, Additional COVID Airway Thoughts with the Actual Audio this Time

Insane, Granular Intubating-Monkey Checklist * Insane Granular Monkey Tube Checklist 2020-04-13 COVID Awake Repositioning and Proning Protocol (CARP) * See the CARP Post Keep 'em from getting Intubated Flow (Adapted from Cam Kyle-Sidell's) * COVID Oxygen Management Flowchart SDW edits Now on to the Podcast...

24 MINAPR 18
Comments
EMCrit 271 – Additional, Additional COVID Airway Thoughts with the Actual Audio this Time

EMCrit Wee – The Philosophy of APRV – TCAV with Nader Habashi

This is part 2 of the APRV - TCAV series. In part 1, I gave a primer on APRV. In this 2nd episode, I speak with the creator of the TCAV method of APRV, Nader Habashi. Nader Habashi, MD, FACP, FCCP Department of Trauma Critical Care Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA Dr. Nader Habashi is a Professor of Medicine at the University of Maryland School of Medicine and the Medical Director of the Multi-trauma Critical Care Unit at the R Adams Cowley Shock Trauma Center (STC) in Baltimore, Maryland, USA. He also serves as the Medical Director for the Respiratory Therapy Department of the STC. Additionally, Dr. Habashi is the Medical Director for the Organ Procurement Organizations in Maryland (The Living Legacy Foundation) and Los Angeles, California (One Legacy). He is board certified in the areas of Internal Medicine, Critical Care Medicine, Pulmonary Medicine and Neuro Critical Care Medicine. Dr. Habashi’s major study interests include alveolar mechanics and mechanical ventilation, mechanical breath profile and clinical management of organ donors. Dr. Habashi collaborates with Syracuse University Medical Center in large and small animal models. COI: Dr Habashi reports presenting at conferences sponsored by or in part by Dräger Medical between 2010 and 2015 for which he received remuneration for honoraria and travel. He is also a founder of Intensive Care On-line Network (ICON) and presented webinars hosted by ICON between 2010 and 2015 and continues to present such webinars and assist clinicians with questions, without any remuneration received. Dr Habashi also reports that he has been issued 2 patents for a ventilation method related to initiating, managing, and/or weaning airway pressure release ventilation and controlling a ventilator in accordance with this method. To date, the patents have not been licensed to any manufacturer and no monetary gain has resulted from the patents. Resolution: No specific companies were mentioned in the podcast. All topics were discussed generically. APRV-TCAV Recruitment of Alveoli Stuff Mentioned * Physiology in Medicine: Understanding dynamic alveolar physiology to minimize ventilator-induced lung injury

37 MINAPR 11
Comments
EMCrit Wee – The Philosophy of APRV – TCAV with Nader Habashi

Latest Episodes

EMCrit 279 – The Decision to use Ketamine – Disruptive and Dangerous with Reub Strayer

EI frequently see both residents and attendings inappropriately using ketamine for agitated patients. Inappropriately both by giving it when it is unecessary and giving it in poor fashion when it is indicated. Our guest today is Reub Strayer (@emupdates). He is the author of EMUpdates.com. His research and clinical interests include checklists and standardization, airway, legislative work on the treatment of opioid dependence, and an approach to opioid misuse in the ED. Reub breaks agitated patients down in to 3 groups: 1. Agitated, but Cooperative Not a problem in the ED. Oral medications or non-pharm techniques. 2. Disruptive without Danger Use standard anti-psychotics and sedatives, with the understanding that Haldol 5mg and Lorazepam 2 mg given IM will take a long time for full effect and even then, may not provide adequate sedation. There are better choices for this group: * Droperidol monotherapy 5-10 mg IM or 5 mg IV * Droperidol 5 mg + Midazolam 2mg IM or IV in the same syringe * Olanzapine 10 mg IM * Olanzapine 5 mg + Midazolam 2 mg IM or IV * Haldol 5 mg + Midazolam 2 mg IM or IV (will be slower than the other choices) If using standard 5/2 (haldol and lorazepam IM), too much time for effect and impatience leads to the wrong subsequent choice, i.e. giving ketamine to this group. 3. Disruptive and Dangerous * dangerous to staff, dangerous to self * danger is relative to the resources of the location Danger could be due to * The agitation itself or * An underlying condition that the agitation is preventing from being treated (and may be the cause of the agitation, e.g. tension pneumothorax) Dividing Line Question: Would you consider intubation to control the situation if ketamine was not available? Reub calls this the Ketamine Litmus Test. Ketamine takedown must be treated as Procedural Sedation (1:1 nursing observation) Intramuscular Medication Administration * Can go through clothes if you need to [Fleming et al.] * Reub states maximum volume of up to 20 mls per injection Ketamine Brain Continuum * See the EMUpdates post by Reub More on this Stuff * Podcast 060 On Human Bondage and the Art of the Chemical Takedown * Podcast 185 Disruption, Danger and Droperidol by Reub Strayer Now on to the Podcast...

23 MIN3 d ago
Comments
EMCrit 279 – The Decision to use Ketamine – Disruptive and Dangerous with Reub Strayer

EMCrit 277 – COVID Pulmonary Physiology with Martin Tobin

Today on the podcast, I interview Martin Tobin on 3 papers he has recently written on COVID pulmonary physiology. Martin Tobin * Praise for Dr. Tobin * Bio Page Caution about Early Intubation in COVID-19 p-SILI From 2 studies, 1 on sheep breathing with a human-equivalent Vt of 502 ml 2nd study was observational with a questionable connection to Vt--it was confounded by a number of other factors Absence of Obtundation L vs. H Subtypes Physio Diversion - Looking for the Patient that needs more Inspiratory Flow * Tobin Vent Review in NEJM Basing Respiratory Management of COVID-19 on Physiological Principles Tachypnea in Isolation is Not an Indication for Intubation Not indicative of increased WOB Avoiding Intubation with NIPPV Correlation of saturation with a host of other evils, but it is possible that the saturation is merely a marker--similar to pH. Vicious cycle of shunt, low SvO2, encephalopathy, decreased resp. drive. COVID has been different, with decreased saturation without the horrible lung injury that normally accompanies it. We are also used to patient discomfort from the disease causing the hypoxemia. Retained good compliance. We have not seen the isolated hypoxemia of COVID in many situations before. The Baffling Case of Silent Hypoxemia Happy Hypoxemia vs. Silent Hypoxemia Dr. Tobin defines silent hypoxemia as PaO2 < 60 mmHg with a PaCO2 >39 mmHg (as a PaCO2 < =39) blunts the dyspneic response to hypoxemia Why don't they have dyspnea vs. why do they have such severe hypoxemia unaccompanied by the degree of standard badness that normally accompanies it They do not crump They don't develop multi-organ Dyspnea Purely subjective Advanced age and diabetes may blunt dypsnea Increase in 10 of PaCO2 causes extreme air hunger Increase Ve when PaO2 <60, but severe hypoxemia elicits increase in ventilation only when PaCO2 > 39 mmHg [32539537] Definition of Hypoxemia Do we need to factor in FiO2? Dr. Tobin and I say no! I define by pulse ox or (PaO2), doesn't matter how much O2. e.g. "He is still hypoxemic despite being placed on NRB." When does Hypoxemia Become Dangerous? Pulse Ox Inaccuracy OxyHemoglobin Dissociation Curve Shifts Fever shifts to the right, Decreased CO2 shifts left Mechanism of Silent Hypoxemia ACE2 is expressed in the carotid body and may be partially to blame COVID breaks our Heuristics Heuristic representation of how bad their lung disease actually is. Projecting expected course... COVID first disease that unlinks it Now on to the Podcast...

32 MINJUL 9
Comments
EMCrit 277 – COVID Pulmonary Physiology with Martin Tobin

EMCrit 276 – The Rapid Code Status Conversation with Kei Ouchi

Today, I am joined by Kei Ouchi to disucss rapid code status discussions in Emergency Medicine and Critical Care. I came across Kei after he put up an amazing post on ALIEM with his co-author Naomi George. Conversation is the essence of palliative care--we need to be experts at them. Kei Ouchi, MD Kei Ouchi is an assistant professor of emergency medicine at the Brigham and Women's Hospital in Boston. He splits his time between EM and palliative care research. [@KeiO97] Kei's and Naomi George's Guide to Rapid Code Status Conversations More to Read * ALIEM Post * Prognosis after intubation study by Kei * Long-term prognosis after MV (Kei's new study) * Functional trajectories of older adults after critical illness * Worse than dying * How patients experience LTACH * Median survival is 8 months if older adults are transferred to LTACH How Kei Trained in Palliative Care Conversations Scott, I realized I’ve never told you anything about how I trained in palliative care communications sk...

34 MINJUN 26
Comments
EMCrit 276 – The Rapid Code Status Conversation with Kei Ouchi

EMCrit 275 – NeuroCritical Care with Neha Dangayach

Today on the podcast, we discuss Neuro-Emergencies and NeuroCritical Care with Neha Dangayach. This is a wide-ranging conversation that you will truly enjoy. Neha Dangayach Neha is joining the EMCrit team!!!!!! Neha S. Dangayach MD, MSCR is an Assistant Professor of Neurology and Neurosurgery. Dr. Dangayach serves as the Director of Neuroemergencies Management and Transfers (NEMAT) for the Mount Sinai Health System, Neurocritical Care Fellowship Director and Research Co-Director for the Institute for Critical Care Medicine (ICCM). She is also a Co-Director of the Mount Sinai Hospital’s busy NSICU and collaborates with a compassionate team to provide world-class patient-centered Neurocritical Care. She leads the Mount Sinai Critical Care Resilience Program (MSCCRP), a multidisciplinary program including intensivists, nursing, social workers, physical, occupation and speech therapists, chaplains, nutritionists among others. Several projects under this program seek to help patients an...

74 MINJUN 10
Comments
EMCrit 275 – NeuroCritical Care with Neha Dangayach

EMCrit 274 – Team Leadership with Cliff Reid

Team leadership is hard [duh]. Teaching it to our trainees is even tougher. When you work in a team of true experts with established implicit communication, things just flow--giving the the team leader the impression that they actually know what the hell they are doing. The mark of a good team leader is how they handle a less than ideal team. I found a true master to interview on the topic of team leadership--friend of the show, Cliff Reid. Attitudinal Choices * Authoritative vs. empowering * Be Aware that many of us are helped or hurt by implicit biases Gender bias paper * Ju et al. Effect of Professional Background and Gender on Residents’ Perceptions of Leadership. Academic Medicine. 2019 Nov;94:S42–7. Prep and Prebrief * Relational Coordination by Purdy et al. from Purdy et al. Where to Stand * Foot of the bed in the opinion of Cliff and me Zero Point Survey (ZPS) * Cliff's Video on ZPS * Perform STEP at the beginning then UP for team recaps Recap / SitRep / Updates-Priorities...

51 MINMAY 27
Comments
EMCrit 274 – Team Leadership with Cliff Reid

EMCrit 273 – Inhaled Pulmonary Vasodilators & Q&A with Sara Crager

This episode continues on from last time's talk by Sara Crager on Right Ventricular Failure. This is a Q&A session with a focus on inhaled pulmonary vasodilators. Nitric Oxide Sara likes it through ETT or Hi-Flo NC (can also be done through BIPAP) Start at 20 ppm See results within 5-10 minutes Monitor with CVP Additional Resources * PulmCrit- Inhaled NO for submassive PE: iNOPE or iYEP? * Review Article on Inhaled NO Epoprostenol (Flolan) May be more complicated to set-up go back to marker 5 Epoprostenol @ 0.05 mcg/kg/min Must have filters on the circuit * Review Article on Inhaled EpoProst Milrinone Get the vial, you want 1 mg/ml with 15 mls in vial 5 ml (5 mg) q 6 hours (According to Dr. Crager--may be more frequent if symptoms rebound (down to q 3 hrs)) Ideally use ultrasonic nebulizer onset ~15 minutes Must have filters on circuit LVOTO & RVOTO contraindication for the milrinone respigard!!! aeroneb pro must have filters on vent from Andre Denault Lecture Additional Resources * Inhaled Pulmonary Vasodilator Therapy for Management of Right Ventricular Dysfunction after Left Ventricular Assist Device Placement and Cardiac Transplantation * A multicentre randomized-controlled trial of inhaled milrinone in high-risk cardiac surgical patients Intratracheal Milrinone Bolus for a Crashing Patient 50-80 mcg/kg or 5 mg (1/2 a bolus is also used by some) onset 4-5 minutes from the amazing Hospitalist & the Resuscitationist Lecture 2019 by Andre Denault Nitro Need conc. of 1 mg/ml (standard bottle is 200 mcg/ml) Doses in studies range from 2.5-25 mcg/kg/min for 10 minutes or 50 ug/kg total given over 8 minutes (perhaps easiest to put 4-5 mg in neb and let it run) * PulmCrit- Nebulized nitroglycerin: The stealth pulmonary vasodilator hiding under your nose? Photo by Valeriia Bugaiova on Unsplash Now on to the Podcast...

26 MINMAY 16
Comments
EMCrit 273 – Inhaled Pulmonary Vasodilators & Q&A with Sara Crager

EMCrit 272 – Right Heart Failure with Sara Crager

We did an amazing episode on EMCrit with Susan Wilcox on Right Heart Failure. However, this oft neglected ventricle deserves even more coverage giving how pesky it can be when it fails. So we brought Sara Crager, MD to Stony Brook to give Grand Rounds. You are going to love this lecture. Part 2 is a Q&A and will be released as a separate episode. This is an embedded Microsoft Office presentation, powered by Office. Now on to the Podcast...

64 MINAPR 30
Comments
EMCrit 272 – Right Heart Failure with Sara Crager

EMCrit Wee – COVID Ventilation Round Table Discussion

Participants Josh Farkas Rory Spiegel Cameron Kyle-Sidell Scott Weingart COVID Low Low PEEP Scale not for clinical use, just a thought provoker Now on to the Wee...

22 MINAPR 25
Comments
EMCrit Wee – COVID Ventilation Round Table Discussion

EMCrit 271 – Additional, Additional COVID Airway Thoughts with the Actual Audio this Time

Insane, Granular Intubating-Monkey Checklist * Insane Granular Monkey Tube Checklist 2020-04-13 COVID Awake Repositioning and Proning Protocol (CARP) * See the CARP Post Keep 'em from getting Intubated Flow (Adapted from Cam Kyle-Sidell's) * COVID Oxygen Management Flowchart SDW edits Now on to the Podcast...

24 MINAPR 18
Comments
EMCrit 271 – Additional, Additional COVID Airway Thoughts with the Actual Audio this Time

EMCrit Wee – The Philosophy of APRV – TCAV with Nader Habashi

This is part 2 of the APRV - TCAV series. In part 1, I gave a primer on APRV. In this 2nd episode, I speak with the creator of the TCAV method of APRV, Nader Habashi. Nader Habashi, MD, FACP, FCCP Department of Trauma Critical Care Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA Dr. Nader Habashi is a Professor of Medicine at the University of Maryland School of Medicine and the Medical Director of the Multi-trauma Critical Care Unit at the R Adams Cowley Shock Trauma Center (STC) in Baltimore, Maryland, USA. He also serves as the Medical Director for the Respiratory Therapy Department of the STC. Additionally, Dr. Habashi is the Medical Director for the Organ Procurement Organizations in Maryland (The Living Legacy Foundation) and Los Angeles, California (One Legacy). He is board certified in the areas of Internal Medicine, Critical Care Medicine, Pulmonary Medicine and Neuro Critical Care Medicine. Dr. Habashi’s major study interests include alveolar mechanics and mechanical ventilation, mechanical breath profile and clinical management of organ donors. Dr. Habashi collaborates with Syracuse University Medical Center in large and small animal models. COI: Dr Habashi reports presenting at conferences sponsored by or in part by Dräger Medical between 2010 and 2015 for which he received remuneration for honoraria and travel. He is also a founder of Intensive Care On-line Network (ICON) and presented webinars hosted by ICON between 2010 and 2015 and continues to present such webinars and assist clinicians with questions, without any remuneration received. Dr Habashi also reports that he has been issued 2 patents for a ventilation method related to initiating, managing, and/or weaning airway pressure release ventilation and controlling a ventilator in accordance with this method. To date, the patents have not been licensed to any manufacturer and no monetary gain has resulted from the patents. Resolution: No specific companies were mentioned in the podcast. All topics were discussed generically. APRV-TCAV Recruitment of Alveoli Stuff Mentioned * Physiology in Medicine: Understanding dynamic alveolar physiology to minimize ventilator-induced lung injury

37 MINAPR 11
Comments
EMCrit Wee – The Philosophy of APRV – TCAV with Nader Habashi
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