EMCrit Podcast

Exploration of reduced-dose fibrinolysis in massive pulmonary embolism, debate on optimal dosing, challenges in publishing device therapy trials, intricacies of balancing TPA and Heparin therapies, personalized dosing for improved outcomes.

Roman Dudaryk, The Trauma Anesthesiologist, discusses optimizing trauma resuscitation strategies, the logistics of massive transfusion in trauma anesthesia, and managing hyperkalemia in trauma patients. Topics include subclavian access, central line placement, tranexamic acid use, and risks of MTP-induced cardioplegia.

Cardiac emergencies expert Mathieu Brunet discusses a case where pulse oximetry failed to confirm Transcutaneous Pacemaker capture, highlighting the challenges of interpreting pulse oximetry waveforms and SVO2 readings in critical care. The podcast explores the complexities of arterial venous shunting, muscular contractions mimicking pulsation, and the need for alternative methods like ultrasound for confirming mechanical capture during pacing interventions.

Exploring the creation and trials of Delayed Sequence Intubation in emergency care. Study comparing RSI to DSI methods show DSI's superior performance. Impact of ketamine on pre-oxygenation and advantages of DSI over RSI highlighted.

The podcast explores managing unstable patients with rapid heart rates, navigating complex tachycardias and treatment dilemmas, differentiating fluid overload and poor left-sided heart function, managing patients in atrial fibrillation with rapid ventricular response, achieving procedural sedation for patient comfort, and navigating a patient's hospital course post-cardioversion.

Nate Shapiro, an emergency physician and professor at Harvard Med, dives deep into the pivotal CLOVERS trial, shedding light on its significance in sepsis treatment. He discusses the debate surrounding fluids versus vasopressors for septic shock, advocating for personalized care over strict protocols. The conversation also tackles the ethical controversies that emerged during the trial, ultimately affirming its ethical standing. Shapiro emphasizes the complexities surrounding fluid management in renal disease, highlighting the need for sound clinical judgment in nuanced treatment decisions.

Exploring the management of severe acetaminophen toxicity, including challenges in diagnosis, lab tests, and NAC dosing protocols. Discussion on femepazol as an ancillary therapy, dialysis recommendations, and treatment strategies. Insights on monitoring liver failure patients and potential NAC interactions with coagulation factors.

Exploring the importance of the Emergency Medicine Mindset and team dynamics in high-pressure situations. Strategies to optimize individual and team performance, especially in 'swarm teams'. Navigating the dynamics of emergency response teams and managing stress for continuous improvement. Enhancing resuscitation team performance through debriefing and effective collaboration. Emphasizing cohesive and mission-driven teams in emergency medicine for optimal performance.

In this discussion, Liz Crow, a staff well-being specialist at Royal Brisbane and Women’s Hospital, shares her journey from pediatric social work to advocating for healthcare staff wellness. She tackles the critical issue of burnout, emphasizing systemic causes rather than personal failings. Listeners learn about different happiness types and the impact of gratitude and relationships on well-being. Liz also highlights the importance of compassion in addressing moral injuries healthcare workers face, especially during challenging times like the COVID pandemic.