In Aortic Dissection, a defect in the aortic intima allows entry of blood into the tunica media. A false lumen develops and can propagate in an anterograde or retrograde direction. Aortic Dissections that involve the ascending aorta (Stanford type A) can cause coronary insufficiency by several mechanisms.
Presentation - 3Ps - Polyuria, Polydipsia, Polyphagia. Non-specific symptoms: weakness, vomiting, abdominal pain, blurry vision. Physical Exam: Acetone smell; Dehydration / tachycardia / hypotension / shock; Kussmaul's respiration (deep/labored breathing secondary to acidosis)
Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs in a mechanically ventilated patient more than 48 hours after endotracheal intubation. VAP can occur in up to 27% of all…
While it is not the only state that defines a critically ill patient, shock is considered by many to be the prototypical derangement of the critically ill. With our bedside…
The approach to the woman with pelvic pain is to start with the initial resuscitation and β-HCG. Then the focus should be on emergent gynecologic disease, such as ovarian torsion and PID / TOA (Tuboovarian Abscess)
Oral anticoagulant medications are commonly prescribed. Whether it is a traditional vitamin K antagonist (VKA) or a novel oral anticoagulant (NOAC) medication, all carry the risk of serious hemorrhage. Traditional…
Sodium bicarbonate is an important antidote in the treatment of the critically ill poisoned patient. This contrasts with the general approach to acidosis due to other conditions, where sodium bicarbonate…
Risk factors for Aortic Aneurysm: smoking, male sex, age, pre-existing atherosclerosis, obesity, Hyperlipidemia, HTN (Hypertension), Family History
Abdominal Compartment Syndrome occurs when elevated intra-abdominal pressure (IAP), or, intra-abdominal hypertension (IAH), leads to new organ dysfunction. The incidence of abdominal compartment syndrome in the ED has not been reported, but in studies of trauma patients, the incidence is between 1% and 14%.
SIRS (Systemic Inflammatory Response Syndrome) is Inflammatory response to a non-infectious insult (pancreatitis, burn, surgery…)