Anand Swaminathan
@emswami.bsky.social
EM doc | Resuscitationist | Medical Educator | EMRAP Managing Editor
He/Him/His
Instagram: @EMSwami
He/Him/His
Instagram: @EMSwami
Preach
So tired of having this conversation
So tired of having this conversation
Patient with cirrhosis and INR of 3 needs a procedure
Please step away from the FFP
EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures)
Plt & fibrinogen are more controversial
Discussion emcrit.org/ibcc/cirrhos... #EMIMCC
Please step away from the FFP
EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures)
Plt & fibrinogen are more controversial
Discussion emcrit.org/ibcc/cirrhos... #EMIMCC
November 27, 2025 at 1:31 PM
Preach
So tired of having this conversation
So tired of having this conversation
Reposted by Anand Swaminathan
Patient with cirrhosis and INR of 3 needs a procedure
Please step away from the FFP
EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures)
Plt & fibrinogen are more controversial
Discussion emcrit.org/ibcc/cirrhos... #EMIMCC
Please step away from the FFP
EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures)
Plt & fibrinogen are more controversial
Discussion emcrit.org/ibcc/cirrhos... #EMIMCC
November 27, 2025 at 1:06 PM
Patient with cirrhosis and INR of 3 needs a procedure
Please step away from the FFP
EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures)
Plt & fibrinogen are more controversial
Discussion emcrit.org/ibcc/cirrhos... #EMIMCC
Please step away from the FFP
EVERY guideline & article agrees that FFP shouldn't be given for pre-procedure coag optimization (even high-risk procedures)
Plt & fibrinogen are more controversial
Discussion emcrit.org/ibcc/cirrhos... #EMIMCC
Tips in Pregnant Patient Resuscitation
-Focus resuscitative efforts on the mother. The better we resus mom, the better the outcome for both
-Access: 2 IV above the diaphragm
-Displace the uterus (Push to L lateral). Tilting can make resus more challenging
youtube.com/shorts/uU0Ya...
#EMIMCC
-Focus resuscitative efforts on the mother. The better we resus mom, the better the outcome for both
-Access: 2 IV above the diaphragm
-Displace the uterus (Push to L lateral). Tilting can make resus more challenging
youtube.com/shorts/uU0Ya...
#EMIMCC
Tips in Pregnancy Resus #criticalcare #emergencymedicine
YouTube video by EMSwami
youtube.com
November 26, 2025 at 2:33 PM
Tips in Pregnant Patient Resuscitation
-Focus resuscitative efforts on the mother. The better we resus mom, the better the outcome for both
-Access: 2 IV above the diaphragm
-Displace the uterus (Push to L lateral). Tilting can make resus more challenging
youtube.com/shorts/uU0Ya...
#EMIMCC
-Focus resuscitative efforts on the mother. The better we resus mom, the better the outcome for both
-Access: 2 IV above the diaphragm
-Displace the uterus (Push to L lateral). Tilting can make resus more challenging
youtube.com/shorts/uU0Ya...
#EMIMCC
Reposted by Anand Swaminathan
1. A landmark study was just published in The Journal of Pediatrics.
It found a 68% reduction in suicidality for trans youth getting HRT.
It also found only 7 of more than 400 stopped taking HRT... and of those that did, 4 still identified as gender-diverse.
Transgender care saves lives.
It found a 68% reduction in suicidality for trans youth getting HRT.
It also found only 7 of more than 400 stopped taking HRT... and of those that did, 4 still identified as gender-diverse.
Transgender care saves lives.
Study In The Journal Of Pediatrics Finds Trans Youth Care Lowers Suicidality, Few Detransition
The groundbreaking study found that suicidality dropped for transgender youth receiving hormone therapy by nearly 70%, with only 7 patients of 432 discontinuing treatment.
www.erininthemorning.com
November 24, 2025 at 11:01 PM
1. A landmark study was just published in The Journal of Pediatrics.
It found a 68% reduction in suicidality for trans youth getting HRT.
It also found only 7 of more than 400 stopped taking HRT... and of those that did, 4 still identified as gender-diverse.
Transgender care saves lives.
It found a 68% reduction in suicidality for trans youth getting HRT.
It also found only 7 of more than 400 stopped taking HRT... and of those that did, 4 still identified as gender-diverse.
Transgender care saves lives.
DOPES Mnemonic: structured approach to deal with hypoxia in the ventilated patient
Displacement, Obstruction, Patient factors (ie PE, PTX), Equipment Issues, Stacked Breaths.
Address all of these factors in parallel
youtube.com/shorts/rwumW...
#EMIMCC
Displacement, Obstruction, Patient factors (ie PE, PTX), Equipment Issues, Stacked Breaths.
Address all of these factors in parallel
youtube.com/shorts/rwumW...
#EMIMCC
DOPES in Crashing Vent #criticalcare #emergencymedicine
YouTube video by EMSwami
youtube.com
November 24, 2025 at 2:34 PM
DOPES Mnemonic: structured approach to deal with hypoxia in the ventilated patient
Displacement, Obstruction, Patient factors (ie PE, PTX), Equipment Issues, Stacked Breaths.
Address all of these factors in parallel
youtube.com/shorts/rwumW...
#EMIMCC
Displacement, Obstruction, Patient factors (ie PE, PTX), Equipment Issues, Stacked Breaths.
Address all of these factors in parallel
youtube.com/shorts/rwumW...
#EMIMCC
Get your flu + COVID shots now!
-Markedly lowers risk of getting COVID/Flu (doesn't eliminate completely)
-Reduces severity of illness
-Reduces likelihood of hospitalization in older, immunocompromised people
-Reduces the risk of transmission to others
youtube.com/shorts/nxPu5...
-Markedly lowers risk of getting COVID/Flu (doesn't eliminate completely)
-Reduces severity of illness
-Reduces likelihood of hospitalization in older, immunocompromised people
-Reduces the risk of transmission to others
youtube.com/shorts/nxPu5...
Flu + COVID PSA
YouTube video by EMSwami
youtube.com
November 23, 2025 at 3:32 PM
Get your flu + COVID shots now!
-Markedly lowers risk of getting COVID/Flu (doesn't eliminate completely)
-Reduces severity of illness
-Reduces likelihood of hospitalization in older, immunocompromised people
-Reduces the risk of transmission to others
youtube.com/shorts/nxPu5...
-Markedly lowers risk of getting COVID/Flu (doesn't eliminate completely)
-Reduces severity of illness
-Reduces likelihood of hospitalization in older, immunocompromised people
-Reduces the risk of transmission to others
youtube.com/shorts/nxPu5...
Reposted by Anand Swaminathan
cosign: isotonic bicarb is great for the renal failure patient with hyperkalemia & acidemia
even if the kidneys take 24-48 hrs to start working, isotonic bicarb resus can often drop the K & improve pH enough to avoid needing dialysis (buys time for renal recovery)
even if the kidneys take 24-48 hrs to start working, isotonic bicarb resus can often drop the K & improve pH enough to avoid needing dialysis (buys time for renal recovery)
Fluids in HyperK
-Restore volume, incr kidney perfusion leading to incr urine output + K elimination
-0.9% saline: pH 5.5, big Cl load. Worsen acidosis leading incr serum K
-LR superior: small amount of K in it won’t raise serum K. Won’t contribute to acidosis
youtube.com/shorts/3G4yc...
#EMIMCC
-Restore volume, incr kidney perfusion leading to incr urine output + K elimination
-0.9% saline: pH 5.5, big Cl load. Worsen acidosis leading incr serum K
-LR superior: small amount of K in it won’t raise serum K. Won’t contribute to acidosis
youtube.com/shorts/3G4yc...
#EMIMCC
Fluids in Hyperkalemia #criticalcare #emergencymedicine
YouTube video by EMSwami
youtube.com
November 21, 2025 at 7:34 PM
cosign: isotonic bicarb is great for the renal failure patient with hyperkalemia & acidemia
even if the kidneys take 24-48 hrs to start working, isotonic bicarb resus can often drop the K & improve pH enough to avoid needing dialysis (buys time for renal recovery)
even if the kidneys take 24-48 hrs to start working, isotonic bicarb resus can often drop the K & improve pH enough to avoid needing dialysis (buys time for renal recovery)
Fluids in HyperK
-Restore volume, incr kidney perfusion leading to incr urine output + K elimination
-0.9% saline: pH 5.5, big Cl load. Worsen acidosis leading incr serum K
-LR superior: small amount of K in it won’t raise serum K. Won’t contribute to acidosis
youtube.com/shorts/3G4yc...
#EMIMCC
-Restore volume, incr kidney perfusion leading to incr urine output + K elimination
-0.9% saline: pH 5.5, big Cl load. Worsen acidosis leading incr serum K
-LR superior: small amount of K in it won’t raise serum K. Won’t contribute to acidosis
youtube.com/shorts/3G4yc...
#EMIMCC
Fluids in Hyperkalemia #criticalcare #emergencymedicine
YouTube video by EMSwami
youtube.com
November 21, 2025 at 2:31 PM
Fluids in HyperK
-Restore volume, incr kidney perfusion leading to incr urine output + K elimination
-0.9% saline: pH 5.5, big Cl load. Worsen acidosis leading incr serum K
-LR superior: small amount of K in it won’t raise serum K. Won’t contribute to acidosis
youtube.com/shorts/3G4yc...
#EMIMCC
-Restore volume, incr kidney perfusion leading to incr urine output + K elimination
-0.9% saline: pH 5.5, big Cl load. Worsen acidosis leading incr serum K
-LR superior: small amount of K in it won’t raise serum K. Won’t contribute to acidosis
youtube.com/shorts/3G4yc...
#EMIMCC
Reposted by Anand Swaminathan
More data outlining how COVID vaccines reduce the risk of hospitalizations & death, especially among those aged 65 and older.
This aligns nicely with recommendations from Canada's National Advisory Committee on Immunization. 🇨🇦
Link: tinyurl.com/yuwmmtt4 by Hansen et al.
This aligns nicely with recommendations from Canada's National Advisory Committee on Immunization. 🇨🇦
Link: tinyurl.com/yuwmmtt4 by Hansen et al.
November 20, 2025 at 6:10 PM
More data outlining how COVID vaccines reduce the risk of hospitalizations & death, especially among those aged 65 and older.
This aligns nicely with recommendations from Canada's National Advisory Committee on Immunization. 🇨🇦
Link: tinyurl.com/yuwmmtt4 by Hansen et al.
This aligns nicely with recommendations from Canada's National Advisory Committee on Immunization. 🇨🇦
Link: tinyurl.com/yuwmmtt4 by Hansen et al.
Priorities in UGIB management: blood, ceftriaxone (if varices suspected), GI to bedside + consider intubation
Finer point: administration of metaclopramide + erythromycin
Promotility agents which help empty the stomach of blood, improve the view for endoscopist
youtube.com/shorts/ae98W...
#EMIMCC
Finer point: administration of metaclopramide + erythromycin
Promotility agents which help empty the stomach of blood, improve the view for endoscopist
youtube.com/shorts/ae98W...
#EMIMCC
Promotility Agents in UGIB #criticalcare #emergencymedicine #resuscitation
YouTube video by EMSwami
youtube.com
November 19, 2025 at 3:20 PM
Priorities in UGIB management: blood, ceftriaxone (if varices suspected), GI to bedside + consider intubation
Finer point: administration of metaclopramide + erythromycin
Promotility agents which help empty the stomach of blood, improve the view for endoscopist
youtube.com/shorts/ae98W...
#EMIMCC
Finer point: administration of metaclopramide + erythromycin
Promotility agents which help empty the stomach of blood, improve the view for endoscopist
youtube.com/shorts/ae98W...
#EMIMCC
SALAD Technique + O2 Desaturation
-Does continuous airway suctioning hasten desaturation?
-ED RCT (PMID: 40533376) found no difference in O2 sat drop between group getting continuous suctioning + group that didn’t
youtube.com/shorts/FE5nA...
#EMIMCC
-Does continuous airway suctioning hasten desaturation?
-ED RCT (PMID: 40533376) found no difference in O2 sat drop between group getting continuous suctioning + group that didn’t
youtube.com/shorts/FE5nA...
#EMIMCC
SALAD Technique + Desataruation #criticalcare #emergencymedicine #airway #intubation
YouTube video by EMSwami
youtube.com
November 17, 2025 at 2:35 PM
SALAD Technique + O2 Desaturation
-Does continuous airway suctioning hasten desaturation?
-ED RCT (PMID: 40533376) found no difference in O2 sat drop between group getting continuous suctioning + group that didn’t
youtube.com/shorts/FE5nA...
#EMIMCC
-Does continuous airway suctioning hasten desaturation?
-ED RCT (PMID: 40533376) found no difference in O2 sat drop between group getting continuous suctioning + group that didn’t
youtube.com/shorts/FE5nA...
#EMIMCC
Sustained polymorphic VT almost ALWAYS unstable. Immediate shock 200J
Torsades de Pointes: polymorphic VT w/ prolonged QT
- Stop QT prolonging meds
- Fix HypoK + HypoMg
- If brady, incr rate (isoproteronol, epi or overdrive pacing)
youtube.com/shorts/IUYDl...
#EMIMCC
Torsades de Pointes: polymorphic VT w/ prolonged QT
- Stop QT prolonging meds
- Fix HypoK + HypoMg
- If brady, incr rate (isoproteronol, epi or overdrive pacing)
youtube.com/shorts/IUYDl...
#EMIMCC
Torsades de Pointes #emergencymedicine #criticalcare
YouTube video by EMSwami
youtube.com
November 14, 2025 at 3:12 PM
Sustained polymorphic VT almost ALWAYS unstable. Immediate shock 200J
Torsades de Pointes: polymorphic VT w/ prolonged QT
- Stop QT prolonging meds
- Fix HypoK + HypoMg
- If brady, incr rate (isoproteronol, epi or overdrive pacing)
youtube.com/shorts/IUYDl...
#EMIMCC
Torsades de Pointes: polymorphic VT w/ prolonged QT
- Stop QT prolonging meds
- Fix HypoK + HypoMg
- If brady, incr rate (isoproteronol, epi or overdrive pacing)
youtube.com/shorts/IUYDl...
#EMIMCC
Nothing normal about “normal” saline
-0.9% NaCl: 154 mEq Na + 154 mEq Cl. pH ~ 5.6
-Human/animal data shows it's proinflammatory
-SALT-ED (PMID:29485926) + SMART (PMID:29485925) show incr kidney injury w/ 0.9% NaCl vs balanced solutions
-LR more physiologic
youtube.com/shorts/XcV7R...
#EMIMCC
-0.9% NaCl: 154 mEq Na + 154 mEq Cl. pH ~ 5.6
-Human/animal data shows it's proinflammatory
-SALT-ED (PMID:29485926) + SMART (PMID:29485925) show incr kidney injury w/ 0.9% NaCl vs balanced solutions
-LR more physiologic
youtube.com/shorts/XcV7R...
#EMIMCC
Nothing Normal About "Normal" Saline #criticalcare #emergencymedicine #resuscitation
YouTube video by EMSwami
youtube.com
November 12, 2025 at 2:33 PM
Nothing normal about “normal” saline
-0.9% NaCl: 154 mEq Na + 154 mEq Cl. pH ~ 5.6
-Human/animal data shows it's proinflammatory
-SALT-ED (PMID:29485926) + SMART (PMID:29485925) show incr kidney injury w/ 0.9% NaCl vs balanced solutions
-LR more physiologic
youtube.com/shorts/XcV7R...
#EMIMCC
-0.9% NaCl: 154 mEq Na + 154 mEq Cl. pH ~ 5.6
-Human/animal data shows it's proinflammatory
-SALT-ED (PMID:29485926) + SMART (PMID:29485925) show incr kidney injury w/ 0.9% NaCl vs balanced solutions
-LR more physiologic
youtube.com/shorts/XcV7R...
#EMIMCC
Check out Building a Better Democracy: bit.ly/3Ltig5v
Alister Martin at the intersection of the ED + Health Policy
This case will ring true to anyone who's worked in EM and, honestly, should be mandatory reading for anyone training in EM: bit.ly/4nQjqW4
Alister Martin at the intersection of the ED + Health Policy
This case will ring true to anyone who's worked in EM and, honestly, should be mandatory reading for anyone training in EM: bit.ly/4nQjqW4
ER Case Files | Case 01: When Medicaid Policy Kills and the Big Beautiful Bill
“We tell people to improve their lives, point to a higher place they can reach, and then booby-trap the staircase to get there. Then we blame them for falling.”
bit.ly
November 12, 2025 at 1:55 PM
Check out Building a Better Democracy: bit.ly/3Ltig5v
Alister Martin at the intersection of the ED + Health Policy
This case will ring true to anyone who's worked in EM and, honestly, should be mandatory reading for anyone training in EM: bit.ly/4nQjqW4
Alister Martin at the intersection of the ED + Health Policy
This case will ring true to anyone who's worked in EM and, honestly, should be mandatory reading for anyone training in EM: bit.ly/4nQjqW4
Permissive Hypercapnia
-Allows CO2 to rise to avoid breath stacking (pH will stay low too)
-Settings: RR 8-10, I:E ratio w/ long expiratory time
-As meds kick in, will relieve bronchospasm which means less expiratory time needed + can start to blow off CO2
youtube.com/shorts/Xblf7...
#EMIMCC
-Allows CO2 to rise to avoid breath stacking (pH will stay low too)
-Settings: RR 8-10, I:E ratio w/ long expiratory time
-As meds kick in, will relieve bronchospasm which means less expiratory time needed + can start to blow off CO2
youtube.com/shorts/Xblf7...
#EMIMCC
Mechanical Vent in Asthma #criticalcare #emergencymedicine
YouTube video by EMSwami
youtube.com
November 10, 2025 at 3:00 PM
Permissive Hypercapnia
-Allows CO2 to rise to avoid breath stacking (pH will stay low too)
-Settings: RR 8-10, I:E ratio w/ long expiratory time
-As meds kick in, will relieve bronchospasm which means less expiratory time needed + can start to blow off CO2
youtube.com/shorts/Xblf7...
#EMIMCC
-Allows CO2 to rise to avoid breath stacking (pH will stay low too)
-Settings: RR 8-10, I:E ratio w/ long expiratory time
-As meds kick in, will relieve bronchospasm which means less expiratory time needed + can start to blow off CO2
youtube.com/shorts/Xblf7...
#EMIMCC
FAST in Hypotensive Trauma
-Start w/ lung/cardiac windows first
-RUQ (+) - changes next destination for management but no immediate intervention
-Lung (+) (ie PTX) or cardiac (+) (ie tamponade) - immediate intervention (thoracostomy/thoracotomy)
youtube.com/shorts/LKmmo...
#EMIMCC
-Start w/ lung/cardiac windows first
-RUQ (+) - changes next destination for management but no immediate intervention
-Lung (+) (ie PTX) or cardiac (+) (ie tamponade) - immediate intervention (thoracostomy/thoracotomy)
youtube.com/shorts/LKmmo...
#EMIMCC
FAST in Hypotensive Trauma #emergencymedicine #criticalcare #trauma #fast
YouTube video by EMSwami
youtube.com
November 7, 2025 at 10:35 PM
FAST in Hypotensive Trauma
-Start w/ lung/cardiac windows first
-RUQ (+) - changes next destination for management but no immediate intervention
-Lung (+) (ie PTX) or cardiac (+) (ie tamponade) - immediate intervention (thoracostomy/thoracotomy)
youtube.com/shorts/LKmmo...
#EMIMCC
-Start w/ lung/cardiac windows first
-RUQ (+) - changes next destination for management but no immediate intervention
-Lung (+) (ie PTX) or cardiac (+) (ie tamponade) - immediate intervention (thoracostomy/thoracotomy)
youtube.com/shorts/LKmmo...
#EMIMCC
Incr safe apneic time important in improving 1st pass success
-Preox w/ NIV: Incr PaO2, recruit alveoli
-Oxygenate + intubate in Bed Up, Head Elevated
-Apneic O2 w/ flush rate NC
-Use rocuronium instead of succinylcholine (up to 45 sec more safe apneic time)
youtube.com/shorts/-3MFR...
#EMIMCC
-Preox w/ NIV: Incr PaO2, recruit alveoli
-Oxygenate + intubate in Bed Up, Head Elevated
-Apneic O2 w/ flush rate NC
-Use rocuronium instead of succinylcholine (up to 45 sec more safe apneic time)
youtube.com/shorts/-3MFR...
#EMIMCC
Safe Apneic Time #emergencymedicine #criticalcare #intubation #airway
YouTube video by EMSwami
youtube.com
November 5, 2025 at 3:03 PM
Incr safe apneic time important in improving 1st pass success
-Preox w/ NIV: Incr PaO2, recruit alveoli
-Oxygenate + intubate in Bed Up, Head Elevated
-Apneic O2 w/ flush rate NC
-Use rocuronium instead of succinylcholine (up to 45 sec more safe apneic time)
youtube.com/shorts/-3MFR...
#EMIMCC
-Preox w/ NIV: Incr PaO2, recruit alveoli
-Oxygenate + intubate in Bed Up, Head Elevated
-Apneic O2 w/ flush rate NC
-Use rocuronium instead of succinylcholine (up to 45 sec more safe apneic time)
youtube.com/shorts/-3MFR...
#EMIMCC
Endovasc Stroke Tx + Airway
-High risk airway decomp: High NIHSS, AMS or Posterior Stroke
-Etomidate a great agent: HD stable
-Avoid hypocarbia (cerebral vasoconstriction)
-After intubation, lie patient flat. Studies (PMID: 40465238) show improved outcomes
youtube.com/shorts/LChtQ...
#EMIMCC
-High risk airway decomp: High NIHSS, AMS or Posterior Stroke
-Etomidate a great agent: HD stable
-Avoid hypocarbia (cerebral vasoconstriction)
-After intubation, lie patient flat. Studies (PMID: 40465238) show improved outcomes
youtube.com/shorts/LChtQ...
#EMIMCC
Intubating in Large Vessel Occlusion Stroke #emergencymedicine #criticalcare #intubation
YouTube video by EMSwami
youtube.com
November 3, 2025 at 3:02 PM
Endovasc Stroke Tx + Airway
-High risk airway decomp: High NIHSS, AMS or Posterior Stroke
-Etomidate a great agent: HD stable
-Avoid hypocarbia (cerebral vasoconstriction)
-After intubation, lie patient flat. Studies (PMID: 40465238) show improved outcomes
youtube.com/shorts/LChtQ...
#EMIMCC
-High risk airway decomp: High NIHSS, AMS or Posterior Stroke
-Etomidate a great agent: HD stable
-Avoid hypocarbia (cerebral vasoconstriction)
-After intubation, lie patient flat. Studies (PMID: 40465238) show improved outcomes
youtube.com/shorts/LChtQ...
#EMIMCC
VT ECG
-ERAD(down I + aVF)
-V6 dominant S wave (all electricity from L heart away from ECG lead)
-RS > 100 msec in precordial leads
-QRS > 160 msec and Either no RSR’ in V1 L rabbit ear > right
In real life, if rhythm fast, wide + regular, assume VT + treat as VT
youtube.com/shorts/glxzf...
#EMIMCC
-ERAD(down I + aVF)
-V6 dominant S wave (all electricity from L heart away from ECG lead)
-RS > 100 msec in precordial leads
-QRS > 160 msec and Either no RSR’ in V1 L rabbit ear > right
In real life, if rhythm fast, wide + regular, assume VT + treat as VT
youtube.com/shorts/glxzf...
#EMIMCC
VTach ECG Features #emergencymedicine #criticalcare #cardiology #resuscitation
YouTube video by EMSwami
youtube.com
October 31, 2025 at 2:15 PM
VT ECG
-ERAD(down I + aVF)
-V6 dominant S wave (all electricity from L heart away from ECG lead)
-RS > 100 msec in precordial leads
-QRS > 160 msec and Either no RSR’ in V1 L rabbit ear > right
In real life, if rhythm fast, wide + regular, assume VT + treat as VT
youtube.com/shorts/glxzf...
#EMIMCC
-ERAD(down I + aVF)
-V6 dominant S wave (all electricity from L heart away from ECG lead)
-RS > 100 msec in precordial leads
-QRS > 160 msec and Either no RSR’ in V1 L rabbit ear > right
In real life, if rhythm fast, wide + regular, assume VT + treat as VT
youtube.com/shorts/glxzf...
#EMIMCC
Reposted by Anand Swaminathan
MASSIVE RCT from Kenya showing that steroids reduce mortality in CAP
Mortality benefit easier to demonstrate w/ less resources available to salvage pts
Should allay the hype that the negative REMAP-CAP steroid RCT received (despite being woefully underpowered)
www.nejm.org/doi/pdf/10.1... #EMIMCC
Mortality benefit easier to demonstrate w/ less resources available to salvage pts
Should allay the hype that the negative REMAP-CAP steroid RCT received (despite being woefully underpowered)
www.nejm.org/doi/pdf/10.1... #EMIMCC
October 29, 2025 at 3:37 PM
MASSIVE RCT from Kenya showing that steroids reduce mortality in CAP
Mortality benefit easier to demonstrate w/ less resources available to salvage pts
Should allay the hype that the negative REMAP-CAP steroid RCT received (despite being woefully underpowered)
www.nejm.org/doi/pdf/10.1... #EMIMCC
Mortality benefit easier to demonstrate w/ less resources available to salvage pts
Should allay the hype that the negative REMAP-CAP steroid RCT received (despite being woefully underpowered)
www.nejm.org/doi/pdf/10.1... #EMIMCC
Reposted by Anand Swaminathan
New RCT: Avoiding A-line in shock didn't affect mortality (trend towards *reduction*) & decreased line complications
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
October 29, 2025 at 3:19 PM
New RCT: Avoiding A-line in shock didn't affect mortality (trend towards *reduction*) & decreased line complications
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
Chest Tube Irrigation After Hemothorax Drainage
-Accumulating evidence shows reduction in complications (reaccumulation, effusions, empyema) PMID: 38764139
-Easy to do: place tube, drain blood, instill 500 cc of NS and suction out
-Can repeat 1-2 times
youtube.com/shorts/QhpAN...
#EMIMCC
-Accumulating evidence shows reduction in complications (reaccumulation, effusions, empyema) PMID: 38764139
-Easy to do: place tube, drain blood, instill 500 cc of NS and suction out
-Can repeat 1-2 times
youtube.com/shorts/QhpAN...
#EMIMCC
Chest Tube Irrigation #emergencymedicine #criticalcare #trauma
YouTube video by EMSwami
youtube.com
October 29, 2025 at 1:31 PM
Chest Tube Irrigation After Hemothorax Drainage
-Accumulating evidence shows reduction in complications (reaccumulation, effusions, empyema) PMID: 38764139
-Easy to do: place tube, drain blood, instill 500 cc of NS and suction out
-Can repeat 1-2 times
youtube.com/shorts/QhpAN...
#EMIMCC
-Accumulating evidence shows reduction in complications (reaccumulation, effusions, empyema) PMID: 38764139
-Easy to do: place tube, drain blood, instill 500 cc of NS and suction out
-Can repeat 1-2 times
youtube.com/shorts/QhpAN...
#EMIMCC
Intubating in elevated ICP
-BP control w/ clevidipine/nicardipine
-Fentanyl: blunt catechol response
-Osmotic agents: 30 cc of 23.4% hypertonic
-Etomidate + rocuronium (no fasciculations, longer safe apneic time)
-Sedation/analgesia ready(bucking tube spikes ICP)
youtube.com/shorts/747a9...
#EMIMCC
-BP control w/ clevidipine/nicardipine
-Fentanyl: blunt catechol response
-Osmotic agents: 30 cc of 23.4% hypertonic
-Etomidate + rocuronium (no fasciculations, longer safe apneic time)
-Sedation/analgesia ready(bucking tube spikes ICP)
youtube.com/shorts/747a9...
#EMIMCC
Intubating Increased ICP #emergencymedicine #criticalcare
YouTube video by EMSwami
youtube.com
October 27, 2025 at 1:35 PM
Intubating in elevated ICP
-BP control w/ clevidipine/nicardipine
-Fentanyl: blunt catechol response
-Osmotic agents: 30 cc of 23.4% hypertonic
-Etomidate + rocuronium (no fasciculations, longer safe apneic time)
-Sedation/analgesia ready(bucking tube spikes ICP)
youtube.com/shorts/747a9...
#EMIMCC
-BP control w/ clevidipine/nicardipine
-Fentanyl: blunt catechol response
-Osmotic agents: 30 cc of 23.4% hypertonic
-Etomidate + rocuronium (no fasciculations, longer safe apneic time)
-Sedation/analgesia ready(bucking tube spikes ICP)
youtube.com/shorts/747a9...
#EMIMCC
Reposted by Anand Swaminathan
Research Roundup (October 2025)
There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs.…
There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs.…
Research Roundup (October 2025)
There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs. AI (Queen of Hearts by PMcardio). Am J Emerg Med. 2025 Jul 30;97:193-199. doi: 10.1016/j.ajem.2025.07.061. Epub ahead of print.
first10em.com
October 27, 2025 at 10:20 AM
Research Roundup (October 2025)
There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs.…
There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs.…
Thyroid storm patients often have high output cardiac failure
-POCUS: LV slamming away more likely to be high output failure
-Beta blockade: slows rate, improves LV filling + cardiac output
-Can use esmolol instead of propranolol as it’s got a short 1/2 life
youtube.com/shorts/Alwol...
#EMIMCC
-POCUS: LV slamming away more likely to be high output failure
-Beta blockade: slows rate, improves LV filling + cardiac output
-Can use esmolol instead of propranolol as it’s got a short 1/2 life
youtube.com/shorts/Alwol...
#EMIMCC
Beta Blockers in Thyroid Storm #emergencymedicine #criticalcare
YouTube video by EMSwami
youtube.com
October 24, 2025 at 1:30 PM
Thyroid storm patients often have high output cardiac failure
-POCUS: LV slamming away more likely to be high output failure
-Beta blockade: slows rate, improves LV filling + cardiac output
-Can use esmolol instead of propranolol as it’s got a short 1/2 life
youtube.com/shorts/Alwol...
#EMIMCC
-POCUS: LV slamming away more likely to be high output failure
-Beta blockade: slows rate, improves LV filling + cardiac output
-Can use esmolol instead of propranolol as it’s got a short 1/2 life
youtube.com/shorts/Alwol...
#EMIMCC