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.
Hemodynamic management of patients with cardiogenic shock centers on vasopressors, inotropes, and mechanical circulatory devices. With respect to inotropic medications, there is little data...
Though we’ve discussed the use of balanced solutions in the resuscitation of critically ill patients numerous times on CCPEM, the literature remains controversial with...
Emergency physicians intubate critically ill patients daily. Unfortunately, up to 17% of ED intubations can be complicated by peri-intubation hypoxemia, hypotension, and cardiac arrest....