Critical Care Perspectives in Emergency Medicine

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Recent blog posts

Modern Management of Cardiac Arrest

Joshua Reynolds Mike Winters Rob Rodriguez Peter DeBlieux

This month, Mike interviews resuscitation expert Dr. Joshua Reynolds on the "Modern Management of Cardiac Arrest".  What are the things you need to focus on to maximize your rates of ROSC and optimize neurologic outcomes for patients in cardiac arrest?  Too many lifesaving pearls in this episode to miss!

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2014: A Year in Review

Mike Winters Rob Rodriguez Peter DeBlieux

We are starting off 2015 with our annual review of key articles from the EM and CCM literature published over the past year.   Key literature in sepsis, cardiac arrest, post-arrest, RSI, and post-intubation management headline the list.  If you want to know the latest in EM/CCM don't miss this episode!

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Critical Care Management of ICH and Antibiotic Pearls

Evie Marcolini Bryan Hayes Mike Winters Rob Rodriguez Peter DeBlieux

This month we have two returning CCPEM favorites, Dr. Evie Marcolini and Dr. Bryan Hayes.  Evie discusses the latest evidence-based care of patients with acute ICH, while Bryan highlights critical pearls and pitfalls in antibiotic therapy.  We couldn't be ending the year on a stronger note!  A can't miss episode!

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Neutropenic Fever and Ebola Virus Disease

Jenny Wilson Mike Winters Rob Rodriguez Peter DeBlieux

This month we focus on ID and Critical Care.  In Part 1, Rob interviews his EM/CCM colleague Dr. Jenny Wilson on pearls and pitfalls in the patient with neutropenic fever.  In Part 2, we discuss management pearls in the patient with Ebola Virus Disease.  This is an absolute can't miss episode loaded with pearls!

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Hemodynamic-directed Resuscitation and Ultrasound in Critical Care

John Greenwood Haney Mallemot Mike Winters Rob Rodriguez Peter DeBlieux

Dr. John Greenwood discusses hemodynamic-directed resuscitation in cardiac arrest patients.  Dr. Haney Mallemat digs deeper into fluid-responsiveness and discusses the pitfalls in the uses of ultrasound IVC measurements and other dynamic markers you can use at the bedside.

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Thrombolytic Therapy in Submassive PE

Mike Winters Rob Rodriguez Peter DeBlieux

Not sure whether to give thrombolytic therapy to your patient with submassive PE?  Does lytic therapy actually improve outcomes?  What are the risks? This month we discuss the key articles from the 2014 literature on submassive, or intermediate-risk, PE.  

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Cardiogenic Shock and ECPR

Semhar Tewelde Mike Winters Rob Rodriguez Peter DeBlieux

Semhar Tewelde joins the podcast this month to gives us the pearls and pitfalls in managing patients with cardiogenic shock. Next, the boys discuss a hot topic in emergency medicine and critical care, extracorporeal CPR. What's the evidence and indications for this novel therapy?

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Refractory Hypoxemia and New Anticoagulant Reversal

Feras Khan Mike Winters Rob Rodriguez Peter DeBlieux

Feras Khan discusses critical therapies for refractory hypoxemia: what works and what therapies should be put to rest in the critical care graveyard. In addition, we discuss the emergent reversal of new oral anticoagulants for patients presenting with life-threatening hemorrhage. Tons of pearls this month!
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TEG and Pearls and Pitfalls in Dissection

Mark Walsh Robert Crawford Mike Winters Rob Rodriguez Peter DeBlieux

Mark Walsh speaks about thromboelastography (TEG) and why you should be using this test to guide transfusions, especially with the massive transfusion protocol. Vascular Surgeon Dr. Robert Crawford gives his pearls & pitfalls on the management of aortic dissection. Forget about memorizing all those classifications; it's easy with his 4 critical points.

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Ischemic Stroke and Severe Acute Pancreatitis

Wendy Chang Mike Winters Rob Rodriguez Peter DeBlieux

Neurocritical care guru Wendy Chang joins the Critical Care Guys to discuss the critical care management of patients with acute ischemic stroke. In part 2, we discuss the current management of patients with severe acute pancreatitis. Still using the term "hemorrhagic pancreatitis"? Still aggressively fluid resuscitating your patient and providing prophylactic antibiotics?
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Vanc/Zosyn is NOT the Answer to Everything

Brian Hayes Michael Allison Michael Scott Mike Winters Rob Rodriguez Peter DeBlieux

Got a sick septic patient? Ready to write for vancomycin and piperacillin/tazobatam? You might want to think again. This month Bryan Hayes is back to discuss 7 pearls that should immediately impact your practice. Michael Allison and Michael Scott review the evidence for the use of noninvasive ventilation in patients with an acute asthma exacerbation.
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ProCESS, Blood Pressure, and Albumin in Sepsis

Mike Winters Rob Rodriguez Peter DeBlieux

This month we review and discuss critical literature just published in the NEJM pertaining to the resuscitation of patients with septic shock. Should you change your MAP goal? Is albumin still indicated for fluid resuscitation in the septic patient? Should CVP and central venous oxygen saturation measurements be integral to the management of patients with sepsis?
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Acute Liver Failure and Tips & Tricks You've Got to Know

Mike Winters Rob Rodriguez Peter DeBlieux

We start off with a discussion on the patient with acute liver failure. Learn why giving lactulose for encephalopathy in these patients may be harmful. In the second discussion, we officially welcome Haney Mallemat to the CCPEM team and hears his Tips & Tricks Every Resuscitationist Must Know!
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Literature Review 2013

Mike Winters Rob Rodriguez Peter DeBlieux

This month we discuss key articles from the 2013 literature that pertain to EM and CCM. Lots of great stuff on cardiac arrest, targeted temperature management, sepsis, transfusions, fluid resuscitation, pulmonary embolism, and sedation and analgesia. Don't get left behind before the year even get's started.
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Pediatric Status Asthmaticus and Status Epilepticus

Mimi Lu Mike Winters Rob Rodriguez Peter DeBlieux

This month we get back to pediatric critical illness. Mimi Lu discusses status asthmaticus while Nate Mick imparts the pearls for treating status epilepticus in sick kids. If you take care of kids, you can't afford to miss this episode!
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Alcohol Withdrawal, Targeted Temperature Management, and Abdominal Catastrophes

Bryan Hayes Mike Winters Rob Rodriguez Peter DeBlieux

Bryan Hayes is back to discuss pearls and pitfalls regarding alcohol withdrawal. We discuss the latest NEJM article that casts doubt on the benefit of cooling patients with ROSC from OHCA to 33C. Finally, we highlight 2 abdominal catastrophes that can easily be missed in the critically ill ICU patient.
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The Sick Transplant Patient

Mike Winters Rob Rodriguez Peter DeBlieux

This month we discuss pearls and pitfalls in the management of critically ill transplant patients. Though we focus on the cardiac transplant patient, much of the discussion on rejection, medications, and infection is applicable to any transplant patient. Do you know how to recognize rejection? What organisms do you need to consider in the transplant patient with sepsis?
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Hypertensive Emergencies

Mike Winters Rob Rodriguez Peter DeBlieux

Often felt to be one of the "most mismanaged conditions in all of medicine", the management of hypertensive emergencies is challenging and can be fraught with disaster. What is the target reduction in blood pressure during the first hour? What agents should you use for select patients and why does hydralazine have no role in the management of hypertensive emergencies?
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Fluid Resuscitation and Critical Management of SAH

Neeraj Badjatia Mike Winters Rob Rodriguez Peter DeBlieux

Recent evidence suggests that the type of fluid selected may impact outcomes. We discuss the acid-base effects of IV fluids, balanced solutions, and the selection of fluids for specific clinical scenarios. Dr. Neeraj Badjatia gives an outstanding talk on the critical care management of patients with SAH. Learn why there is "nothing normal about normal saline".
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The Intubated ED Patient: Mistakes You Don't Want to Make!

Sam Wood Mike Winters Rob Rodriguez Peter DeBlieux

This month Sam Wood joins the podcast and delivers an amazing lecture on caring for the intubated ED patient. Packed with pearls and pitfalls, this podcast is one you'll want to listen to a few times. Miss this episode and you may just find yourself the center of the next M&M conference.
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