A case everyone needs to know: A man admitted for CHF exacerbation is normoxic on ambient air. POCUS shows bilateral pleural effusions. He develops Afib w/ RVR (HR 150s). A med is given. Suddenly he develops hypoxemia (SpO2 84% on NC, 94% on NRB). What med & what happened? 1/

CRRT🆚IHD as the initial modality: a post-hoc analysis of The STARRT-AKI Trial After PS matching, CRRT was associated with a reduced risk of death and RRT dependence at 90 days (OR 0.81 [0.66–0.99]), driven by less frequent RRT dependence (OR 0.61 [0.39–0.94]). 🔗doi.org/10.1007/s00134…

Today's paper of the day is on how assessing hemodynamics can help to assess volume status criticalcarereviews.com/latest-evidenc… Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2023

Bro ain’t nobody catching ANYTHING he throws 😭😭

Myth 3: Oliguria needs a furosemide bolus The “Oligo-Frus Reflex” Fight against it folks 👊

#EchoFIRST Hepatic vein M-COLOR mode is all you need! Jae K. Oh would you agree?

Are you looking for interesting manuscripts for your Journal Clubs in critically ill patients? Here are 14 ideas: ➡️All RCTs ➡️All published in 2023, ➡️all NEJM Half of them with stat significant differences in primary endpoint (or mortality) In order of importance 1/15

Ventilator Riddle: You press Inspiratory hold & this happens! What’s going on here? 1/

1/10 Avoiding a PA catheter #PAC nightmare! (bookmark this) Evening rounds in ICU. Pt with #PAC in place. “Wedge” 25 mmHg 2d ago. Great diuresis since. Last 8h urine output is ⬇️ Time for wedge recheck You fully inflate the #PAC balloon (1.5 cc) 1m later, heme is pouring👇🏻

ED Patients (non pregnant <65 yrs) With Severe Agitation - ACEP policy Use droperidol/midazolam combo If a single agent → droperidol If no droperidol → atypical antipsychotic (eg olanzapine) When safety calls for immediate sedation → KETAMINE acep.org/siteassets/new…

Left ventricular hemodynamics on VA #ECMO?? Physiology insights from catheterization & 3D echo 🫀 high flow VA #ECLS decompresses LV by significantly ⬇️ LV preload with minimal ⬆️ in afterload 🫀 this ⬇️ LVEDP, LVEDV, LV stroke work, LV PVA #FOAMcc 🔓 bit.ly/47U4Ip5

Concomitant VA #ECMO & #Impella (= ECpella or ECMella) in cardiac arrest, #FOAMcc on asaiojournal 🔓 bit.ly/3SeqJsV 🩸 #ECPR + 🖥️ #TEE in ED for rapid decision-making (cannula positioning, assessment of cardiac function, guide EBF adjustments, confirm AV

(1/6): 5 myths of IV fluids 🦄 A 🧵that makes my soul cringe. Please help spread the word 🙏#stopinhospitaldrowning

Lung Ultrasound and Pleural Artifacts: A Pictorial Review CCR Journal Watch criticalcarereviews.com/latest-evidenc… Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/su…

Over 800 police officers were at the parade today and over a million civilians who were allowed to be armed. Yet they couldn't stop a dozen people from being shot. More guns makes us less safe. #ChiefsParade kmbc.com/article/shooti…

Excited to announce GEMS-Rx was published today in Annal of EM! Thank you to ACEP Geriatric Sect and all co-authors! Geriatric Emergency Medication Safety Recommendations (GEMS-Rx): Modif... sciencedirect.com/science/articl…

Doppler For fellows. Pulmonary Doppler of a 56 yr old female with right heart failure due to EMF and fibrosed calcified small RV. What is the “physiology” called?

Dr. Donna Sweet, MACP, receiving the ACP PACS Award ⁦Texas Chapter ACP⁩ ⁦ACP⁩ ⁦Kansas ACP⁩ ⁦@sue_bornstein⁩

If you intubate you need to read the #PREOXI trial! -n=1301 people requiring intubation in ED/ ICU were randomized to preoxygenation with oxygen mask vs non-invasive ventilation (NIV) -NIV HALVED the risk of hypoxemia: 9 vs 18% -NIV reduced mortality: 0.2% vs 1.1% #CCR24 🧵 1/

annemergmed.com/article/S0196-…