Managing acute critical care transport medicine cases

In this podcast episode, Dr. Mike Betzner discusses the challenges faced in critical care transport medicine when there is a lack of evidence-based guidance. He presents a case of a 74-year-old woman with severe shortness of breath and peripheral edema, who was in a small rural hospital without access to dialysis. Despite starting nitroglycerin, the patient still struggled to breathe and remained significantly volume overloaded. To address this, a venodilator circuit was used as an alternative to CPAP or BIPAP. Additionally, in the absence of immediate access to dialysis, the volume was rapidly reduced by phlebotomy, resulting in a dramatic improvement in the patient's condition.