Critical Care Perspectives in Emergency Medicine

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Recent blog posts

Mechanical Circulatory Support Devices

Peter DeBlieux John Greenwood Mike Winters

What do you do for the patient in cardiogenic shock who is not responding to vasopressors and inotropes?  Should you place a mechanical circulatory support device as a bridge to PCI or CABG? We discuss the pearls and pitfalls of the latest devices.

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An Approach to Refractory Hypoxemia

Peter DeBlieux John Greenwood Rob Rodriguez Mike Winters

The use of a PEEP recruitment maneuver is common among ventilated patients with refractory hypoxemia.  However, a recent JAMA study questions whether we should be using this in our patients.  In this podcast, we discuss this article and an approach to the patient with refractory hypoxemia while on the ventilator.

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Noninvasive Ventilation for the Emergency Physician

Peter DeBlieux John Greenwood Mike Winters

We know NIV works well for patients with acute COPD or acute CHF exacerbations.  In this episode, we discuss the evidence for NIV not only in COPD and CHF, but also a myriad of other conditions.  Do you know what the latest guidelines say on NIV for asthma, immunocompromised patients, or undifferentiated acute respiratory failure?  Take a listen...

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ED Mechanical Ventilation Pearls

Peter DeBlieux John Greenwood Rob Rodriguez Mike Winters

In this podcast we discuss the pearls and perils of ED mechanical ventilation.  What are the numbers you NEED to know? We also discuss the critical points of post-intubation analgesia and sedation.  Still providing benzo's to your intubated ED patient?  Better listen to this episode!

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Hyponatremic Encephalopathy

Peter DeBlieux John Greenwood Rob Rodriguez Mike Winters

Hyponatremia is one of the most common electrolyte disorders encountered in emergency medicine and critical care.  Patients with hyponatremic encephalopathy represent a severe form of hyponatremia that must be rapidly treated.  In this episode, we discuss pearls and pitfalls in treating this critical condition.

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Resuscitating Under Stress!

Peter DeBlieux John Greenwood Rob Rodriguez Mike Winters

Resuscitations are often chaotic events.  How we perform under pressure can make the difference between life and death.  In this podcast, we discuss a recent article in print in Annals of Emergency Medicine on performing well under stress. This may be one of the most important podcasts of the year!

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Angiotensin II for Vasodilatory Shock?

Mike McCurdy Mike Winters

This month Mike McCurdy rejoins the podcast to discuss the ATHOS-3 trial.  Mike was one of the co-authors on this impressive publication and gives us insight into the study and its results.  Very thought provoking!

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Pediatric and Neonatal Septic Shock

Barrie Bostick Mimi Lu Mike Winters

Peds EM superstars Mimi Lu and Barrie Bostick join CCPEM to review the latest clinical guidelines on hemodynamic support of pediatric and neonatal septic shock.  This episode is loaded with pearls for the resuscitation of your next septic pediatric patient!

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Intubating & Ventilating the Obese Patient

Ken Butler Rory Spiegel Mike Winters

Rory Spiegel and Ken Butler join the podcast to discuss critical issues in intubating and ventilating the obese patient.  What physiologic changes do you NEED to know?  What is appropriate dose of RSI meds in the obese patient?  What are the initial ventilator settings?  These experts answer these questions and so many more!

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Euglycemic DKA

Peter DeBlieux John Greenwood Rob Rodriguez Mike Winters

We discuss the case of a young patient presenting with euglycemic DKA.  Say what?  How common is this entity and what is the impact of a new class of diabetic medication?  We answer these important questions and much more on this episode.

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Should We Treat Fever in Septic Patients?

Peter DeBlieux John Greenwood Rob Rodriguez Mike Winters

Several recent articles have challenged the long-held belief that we should treat fever in patients with sepsis.  In this episode we review these recent studies, along with the benefits of fever in patients with an infection.  A very timely and controversial topic!

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Top 10 Pearls for the Critically Ill Elderly Patient

Peter DeBlieux John Greenwood Rob Rodriguez Mike Winters

The number of critically ill elderly patients continues to increase annually.  In this podcast, we discuss key pearls and pitfalls in resuscitating the sick elderly patient.  A truly great discussion!

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High-Dose NTG in ACPE

Mike Winters Jill Logan

ED Pharmacist extraordinaire Jill Logan joins CCPEM to discuss the use of high-dose nitroglycerin in patients with acute cardiogenic pulmonary edema.  Is it safe?  How much can, and should, you give during the initial resuscitation of these sick patients?

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Family Centered Care in the Critically Ill

Peter DeBlieux Rob Rodriguez Mike Winters John Greenwood

New guidelines have just been published on the care of family members of critically ill patients! So many family members of critically ill patients have significant problems, including PTSD and depression, in the months following the ICU stay of their loved one.  Peter, Rob, Mike, and John review select recommendations of these new guidelines.  Incredibly important content this month!

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Surviving Sepsis Campaign 2016 Update

Mike Winters Peter DeBlieux Rob Rodriguez John Greenwood

The SSC recently published its new recommendations for the management of sepsis and septic shock.  We discuss the key changes and controversies that you need to know regarding these latest guidelines!

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The Complicated Alcohol Withdrawal Patient

Mike Winters Bryan Hayes

Bryan Hayes is back!  In this podcast, we discuss pitfalls in the use of benzodiazepines along with current evidence on adjunctive treatments including propofol, barbiturates, dexmedetomidine, antiepileptics, and ketamine.  Bryan brings us all up to date with this discussion!

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Top Articles of 2016

Peter DeBlieux John Greenwood Rob Rodriguez Mike Winters

It's time for our annual literature update of the best and most discussed articles from 2016!  Simply a great discussion on important topics such as ICH, cardiac arrest, mechanical ventilation, RSI, and sepsis.

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Sepsis Resuscitation Part II: The Microcirculation

Mike Winters John Greenwood

We continue our discussion on sepsis resuscitation by focusing on the microcirculation.  Is ScvO2 dead or can it still provide useful information in select patients?

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Will My Patient Respond to Fluids?

Mike Winters Rob Rodriguez Peter DeBlieux

The administration of IVFs is one of the most common interventions in caring for critically ill ED patients.  But when is enough, enough?  Peter, Rob, and Mike discuss a recent article that summarizes the current evidence on determining who will, and who won't, respond to IVFs.

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The Crashing Patient with Pulmonary Hypertension

Mike Winters Rob Rodriguez Peter DeBlieux

This month we cover the critical pearls and pitfalls in resuscitating the crashing patient with pulmonary hypertension.  These patients are incredibly sick and can crash in minutes.  Miss this episode and you may be left wondering why additional IVFs are actually making this patient more hypotensive!

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