Acute mental status changes after the ingestion of alcohol or other substances are a common presentation to the ED. Those with severe obtundation may require intubation for airway protection while the substance metabolizes. In fact, more than 20,000 patients are intubated each year in the United States for acute poisoning or intoxication. Notwithstanding, intubation and mechanical ventilation are not benign procedures. In this podcast we discuss the recently published NICO Trial, that evaluated a strategy of withholding intubation in patients with coma due to acute poisoning.
Over 80% of patients with sepsis receive care in the ED. Despite evidence demonstrating the benefits of ED sepsis resuscitation, there remains significant controversies...
Ventilated ED patients may be at high risk for awareness with paralysis, thereby increasing the risk of long-term psychological sequelae. In this podcast, we...
Etomidate and ketamine are frequently used for RSI in critically ill patients. Recent articles have raised concern about an increased incidence of post-intubation hypotension...