EM/IM Sessions

EM/IM Sessions: Preoxygenation with Flush Rate O2

Preoxygenation With Flush Rate Oxygen: Comparing the Nonrebreather Mask With the Bag-Valve Mask Driver, Brian E et al. Annals of Emergency Medicine, March 2018. [paper] Why I chose this study While preoxygenating during rapid sequence intubation for spontaneously breathing patients, I’ve typically used bag valve mask (BVM) and nonrebreather mask (NRB) interchangeably. This is mainly based

Critical Care

We Have No Beds: Ventilator Series

We Have No Beds: Ventilator Series Assist Control So now that we have discussed how to read a ventilator screen, let’s discuss our first mode of ventilation… Assist Control (AC) This mode has the ability to completely control the patients ventilatory status. With this mode you set the rate, the means by which tidal volume is

Critical Care

The Sedation Vacation

Sedation Vacations in the Intensive Care Unit Sorry, pure EM folk, this topic primarily applies to the unit. For most of us, the idea of a “daily sedation vacation” is probably a familiar and standard practice in the intensive care unit (ICU). Generally defined, a sedation vacation is when sedatives are discontinued for a period

Knowledge Bomb

Knowledge Bomb: LOV-ED Trial

We continue on with the series with Knowledge Bomb #15. The purpose and motivation for this series is outlined in the first entry and extensively in an ALiEM IDEA series blog entry. Background: Annually, 250,000 patients are mechanically ventilated in US Emergency Departments (ED). Of these patients, 20% will develop complications such as Acute Respiratory Distress Syndrome (ARDS) or

Critical Care

We Have No Beds: Ventilator Series

We Have No Beds: Ventilator Series Reading a Ventilator Screen Before diving into a specific mode of ventilation, we should address what you see on a ventilator screen first.  What do all these abbreviations mean?… Note: the pictures and order of descriptions reflect the Puritan-Bennett 840 ventilator.  However, most of the information will reflect most

Knowledge Bomb

Knowledge Bomb! Elevate Head of Bed for Intubation

We continue on with the series with Knowledge Bomb #9. The purpose and motivation for this series is outlined in the first entry. This entry we discuss a different technique for intubation of patients. Background Intubation is a popular topic in emergency medicine and everyone has an opinion on the best technique. Video laryngoscopy only? First

Knowledge Bomb

Knowledge Bomb! – Apneic Oxygenation during Intubation

Article Randomized Trial of Apneic Oxygenation during Endotracheal Intubation of the Critically Ill. Why!? Airway management is a cornerstone of emergency medicine and critical care medicine. Patients who require either aggressive oxygenation or airway protection (and to a lesser extent, others with indications for endotracheal intubation) are at risk for hypoxia during Efforts Securing A

Critical Care

Conference, 7/16/15, Mercy, Critical Care

ACLS/Sick vs Not Sick with Dr. Jess Barber: Good, consistent, uninterrupted compressions are essential in any code Compressions, defibrillation, running a systematic code are more important than intubation In tachycardia, stable vs unstable should be your first question Treat every patient you are coding like you would treat a loved one Drug Choices for Sedation