EMCrit FOAM Feed - podcast cover

EMCrit FOAM Feed

Scott D. Weingart, MD FCCMemcrit.org
Help me fill in the blanks of the practice of ED Critical Care. In this podcast, we discuss all things related to the crashing, critically ill patient in the Emergency Department. Find the show notes at emcrit.org.
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Episodes

EMCrit Wee - ECGs in Acute Pulmonary Embolism

Dr. Scott Weingart and Dr. Pendle Myers explore the challenges of using ECGs to diagnose acute pulmonary embolism, emphasizing the medicolegal risks of missed diagnoses. They detail specific ECG patterns indicative of right heart strain, provide a differential for anterior T-wave inversions, and discuss how conditions like right bundle branch block complicate interpretation. The conversation also touches on ECG scoring systems and the potential of AI to enhance diagnostic accuracy.

Feb 02, 202631 min

EMCrit Wee - EVERDAC RCT on Arterial Line Placement in the Medically Critically Ill

The EVERDAC trial, a well-conducted randomized control study, found no mortality or organ failure benefit from early arterial line placement in over a thousand critically ill ICU patients. While arterial lines did show more minor complications like hematomas, the study validated that non-invasive blood pressure monitoring is sufficient for mean arterial pressure in most cases, even in very sick patients. The discussion also covers when arterial lines might still be indicated and the ongoing debate between convenience and patient safety.

Dec 03, 202520 min

EMCrit 413 - Translating Recent Sepsis Papers to the Bedside with PulmCrit (Farkas)

Scott Weingart and Josh Farkas (PulmCrit) critically analyze recent sepsis trials, primarily Andromeda Shock 2, to provide actionable bedside insights for septic shock management. They discuss the trial's implications as a proof of concept, advocating for personalized therapy over rigid protocols, especially regarding the use and interpretation of capillary refill time (CRT) and perfusion index. The conversation delves into the nuances of blood pressure augmentation, vasopressor selection in light of trials like Optopress, and a strategic approach to fluid administration and inotropic support, highlighting the importance of objective perfusion markers.

Nov 29, 202536 min
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