EMCrit Podcast - Emergency Critical Care

Organ Donation in the Emergency Department Though it may not seem as important as some of the things we do in ED Critical Care, managing the potential organ donor can lead to many lives saved. In this episode I interview Isaac Tawil, an Emergency Intensivist of University of New Mexico Health Sciences and associate medical director of New Mexico Organ Donor Services. Here are the current standards for determining brain death Wijdicks et al. Evidence-based guideline update: Determining Brain Death in Adults Here is a video of Dr. Tawil demonstrating the brain death exam

Jeff Kline is the master of all things pulmonary embolism in emergency medicine. This is a lecture he gave on fibrinolysis for pulmonary embolism. He discusses both massive and sub-massive PE.

This is Part 4 of the Acid Base saga. In this episode, I discuss the acid base effects of fluids and when and how to use sodium bicarbonate.

Richard Dutton is a trauma anesthesiologist who was one of the primary formulators of the concept of 1:1:1 resuscitation. Here he is speaking on hemostatic resuscitation.

This Part I of the Mind of a Resus Doc Series, in which we delve into the philosophies that make a good resuscitationist.

A few months ago, we had Dr. Stephen Smith on the podcast to discuss a variety of EKG issues. Dr. Smith has an EKG blog that is required reading for every ED and ICU doc. This is Part II and I think it discusses an incredibly important issue: right now major medical societies including the AHA and ACEP are asking us to fibrinolyse or PCI patients with new or presumed new LBBB. However, your interventionalists will tell you that this strategy is a ridiculous waste given how few acute occlusions will actually be found. Why this discrepancy?

Cliff Reid of Resus.Me fame put out an incredible post on NAP4, the audit done on all of the airway complications in Great Britain. It was such a phenomenal post that I got in touch with Cliff and asked if he wanted to come on the podcast to speak about it. He did me one better and got an interview with one of the authors of the Emergency and Critical Care Section.

In part III, we go through 2 cases of acid base abnormalities step by step.

It can be a b*tch to pass the esophageal temperature probe for hypothermia. Here's how to get er done.

This second lecture discusses a quantitative approach to acid base management. I lay out the formula I use to approach an acid-base problem.

This lecture discusses a quantitative approach to acid base management. This is also known as the Fencl-Stewart approach, the strong-ion approach or the physicochemical approach. It provides explanations for why acid base disorders occur in human pathophysiology.

Since we had the Kayexalate episode, I did not want to do a full podcast, so I thought I would just air some listener questions:

Dr. Siamak (Mak) Moayedi, MD found nothing to indicate that kayexalate is effective for the acute management of hyperkalemia.

Here is a video to go along with podcast 43 on the insertion and use of the Air-Q intubating laryngeal airway

My favorite supraglottic airway is the Cookgas Air-Q; it was created by an anesthesiologist, Dr. Daniel Cook. He just created a new device that allows the placement of an esophageal blocker through the laryngeal airway. I gave him a call to hear about the new product and in the course of that conversation, he gave me a ton of tips on the placement of laryngeal airways. Part II will specifically discuss the new device.