EM Mastery Peter Kas

This is a low frequency High stakes Disease we cannot miss.

Here is a controversial paper with mortality findings very different to what has been published before. The Community-Acquired Pneumonia: Evaluation of Corticosteroids (CAPE COD) Trial, was a double-blind, randomised, controlled, superiority trial, conducted in 31 French ICUs.Intravenous hydrocortisone, 200mg, was given within 24 hours of onset of severity criteria (median time 15 hours). The results were very different to the previous study conducted in 42 ICU centres.

Airway in Cardiac Arrest is still a bit of a mystery. We don't really know if we should intubate early. Contrary to prior studies showing no benefit of intubation over BVM or SGA, new evidence may be pointing in a different direction. We don't know the correct rate of breaths or volume of breaths or FiO2. Small animal studies and 'expert' opinion restrict our delivery of breaths to a maximum of 10 per minute and the volume of each breath to about 500 mL. This has resulted in some centres now using paediatric BVMs for adult resuscitation. Do these work? Previous studies may have shown no inferiority, but here is a new study, that suggests that traditional BVMs may be better.

The Clinical Cases Podcast, also called The EM Show. Coming to EM Mastery Soon

A patient presents feeling dizzy when standing. His ECG shows he is in Atrial Flutter with a variable block. The block is significant. In some places it is 8:1. His blood pressure is 130 mmHg systolic. He is normally on Diltiazem. What should we do?

How do you approach the patient in shock? Septic shock, Cardiogenic Shock, shock due to a massive pulmonary embolism?There is no perfect drug, however Noradrenaline may be as perfect as it gets.