EMCrit Podcast Network

•

Chaîne • 3 émissions

Médecine

Médecine

Toutes les 2 semaines
Développement personnel

Développement personnel

Toutes les 2 semaines
Médecine

Médecine

Tous les mois

10/12/2022

ODR 004 – Email is Not the Problem, You Are! [Email Part 1/X]

The ODR PodcastOn Deeper Reflection is a podcast on making our lives as happy and productive as possible! Today’s episode deals with the bugbear of many in medicine–email. Part II is now Up as Well 1. Understand the TechnologyEmail is an amazing Technology!Async-MailSync-Phone, Telegraph, Text, Chatapps,Email-Asynchronous with instant delivery–but this should not mean instant viewingPhilosophy is wrong, not tacticsBad SolutionsAn article on just keeping emails in inbox misses the entire point. There are only two acceptable solutions and ignoring email is definitely one of them, but inbox zero is the better version of that.Inbox ZeroArrival Rate vs. Departure RateEvery inbox item costs you decision dollarsWe don’t want to make decisionsToo Much Email-No!!!!! Too Much StuffI Just Check Once Per DayVs. I set aside time to do Deep WorkAnalogous to I took Facebook off my phone… 2. Email Should Spark JoyUsed to have combined work and homeNever, ever do this!!!! Separate Work and EmailWork Check Once, while at work or every day depending on your jobHorrible human being would email on Friday afternoon with something horrible 3. Don’t treat an async tech as syncDon’t expect or encourage real-time useIt is fine to reply right away, but dissuade the belief that you will consistentlyPacing 4. Your Email Inbox cannot be your ToDo system5. Just 1 TouchDoItSystemItDelegateItSaveItUnsubIt-goes back to brings joy, true joy–not dopamine hitFilterItTrashit (actually archive)SpamItMaybe-Bringit Back Services 6. Archive, Don’t Delete7. Search, Don’t File8. Inbox Elimination to Keep You HonestToo Many InboxesGmail Mailboxes 9. Cut out Back & Forth Steps10. For Some Use cases, Are Slack/Basecamp/Teams the Solution?Books to ReadYou need to prune down to what is important!!!Life Changing! We’ll do a book
25/04/2009

EMCrit Podcast 1 – Sympathetic Crashing Acute Pulmonary Edema (SCAPE)

Here it is, the 1st EMCrit podcast. It's on the topic of Sympathetic Crashing Acute Pulmonary Edema (SCAPE). This condition is on a very different part of the disease spectrum from FOPE (Fluid-Overload Pulmonary Edema, an acronum I first saw used by by @Cameronks) To boil it down to 10 seconds: Start patient on Non-invasive ventilation with a PEEP of 6-8; quickly titrate to a PEEP of 10-12. Start the patient on a nitroglycerin drip. Administer a loading dose of 4oo mcg/min for 2 minutes (120 ml/hour on the pump for 2 minutes with the standard nitro concentration of 200 mcg/ml.) Then drop the dose to 100 mcg/min and titrate it up from there as needed. By 10 minutes, your patient should be out of the water. See crashingpatient.com for the references. Here is some info from a handout from a lecture I gave on the topic: High Dose Nitroglycerin Homeopathic nitroglycerin does not work so well Start at 50-100 mcg/min, you can rapidly titrate to 200-400 mcg/min. You must stand at the bedside to use these doses. Need >120 mcg/min to get sig decreased Pulm Cap Wedge Pressure (Am J Cardio 2004;93:237) But even this strategy is not as effective as the … Nitro Bolus First Can give 400-800 mcg over 1-2 minutes = 400 mcg/min for 1-2 minutes. (Annals EM 1997, 30:382) How to do it Standard nitro mix is 200 mcg/ml. VERIFY YOUR HOSPITAL’S MIX BEFORE USING THESE RECS In order to give the 400 mcg/min for 2 minutes, set the pump to Rate: 120 cc/hr Volume to be Infused: 4 ml (This will deliver 400 mcg/min for 2 minutes and then stop) Or Draw up 4 ml of the nitro and 6 ml of NS and give over 2 minutes After the bolus, I drop the drip to 100 mcg/min and titrate up from there to effect When the patient gets better, you need to sharply decrease this drip rate Some folks have gone even further High dose nitroglycerin for severe decompensated heart failure—2 mg at a time (Ann Emerg Med 2007;50:144) Cotter gave isosorbide 3 mg q 5 minutes with good results in his study. This is equivalent to nitro 600 mcg/min. (Lancet 1998 351:9100, 389-393) Bolus intravenous nitroglycerin predominantly reduces afterload in patients with excessive arterial elastance (Journal of the American College of Cardiology Volume 22, Issue 1, July 1993, Pages 251–257) Update Piyush Mallick did an amazing study on nitro-bolus to avert intubation Someone finally put the term into the literature (Agrawal N, Kumar A, Aggarwal P, Jamshed N. Sympathetic crashing acute pulmonary edema. Indian J Crit Care Med 2016;20:719-23) 1-2 mg bolus doses are safe and effective (American Journal of Emergency Medicine 2017, 35 (1): 126-131) How you set-up the drip sig. affects time to med (Douma MJ, O'Dochartaigh D, Corry A, et al How intravenous nitroglycerine transit time from bag-to-bloodstream can be affected by infusion technique: a simulation study Emerg Med J 2015;32:498-500.)
19/10/2025

EMCrit 410 - What PulmToilet Taught Me About Views on SCAPE (Sigh...)

EMCrit FOAM Feed
03/09/2022

ODR 001 – Getting Shit Done (GTD) [Part 1/x]

So my friend Michelle Lin was kind enough to solicit a “How I Work Smarter” piece on her excellent ALIEM blog. One of the things I mentioned in that piece was a book called Getting Things Done. I’ve since gotten a bunch of questions and comments about the book. I’d like to take a brief diversion from the main topic of EMCrit and discuss a bit about the book and productivity for docs and resuscitationists. GTD on ODR The BooksGetting Things Done by David Allen (A new edition, the first in years will be out in 3-4 months)The Organized Mind The PhilosophyA clear mind eliminates stress and allows creativity, so… Capture all the things that need to get done into a logical and trusted system outside of your head and off your mind, and… Discipline yourself to make decisions about all the inputs you let into your life, so that you will always have a plan for next actions that you can implement or renegotiate at any moment (altered from Mindzone Wiki) Problems with the BookMindset of the AuthorBased on an erstwhile paper-based worldCan be read as Dogma The Steps of GTDCollect/Process/Organize/Review/Do 1. Collection/Universal CaptureIndex CardsDrafts for IOS Inbox(es)EmailPaper Landing Station (The Traditional/Actual Inbox)Pocket for Web and IOS 2. ProcessWhat is it?Is it an action, spam, or something non-actionable you want to keep? Action ProcessingDecide if you want to Do it, Don’t do it, Delegate it, or Put it in your systemIs it a project?What is the physical next action that must occur to bring you 1 step closer to completion Next Actions & Projects Reference ProcessingThings you just want to keep or references for actions Eliminate Paper! EvernoteScansnap Scanner (this item will change your life) 3. Organize-If you are not doing it right now, put it in the systemNirvanaHQ or OmnifocusGCal with FantasticalAdd all reference material as links in your...
01/03/2023

ODR 007 – Liberterian Free Will, Blame and Shame

This Article is a Must Read if you Found this Episode on Free Will InterestingThe Lucretian Swerve AttributionsWhile 1% of this episode may be independent thinking, the rest was surely based on influences too countless to cite. Some that clearly remain foremost as inspiration are the article above, Dan Dennett’s work, Sam Harris’ book, the book, Four Views on Free Will, and all by poor undergrad professors that had to put up with the utter annoyance of my stubbornness. One of the Most Critical Articles to Read on the TopicChun SS et al. Unconscious determinants of free decisions in the human brain. Nat Neurosci. 2008 May;11(5):543-5. PMID: 18408715 Image by Narcournus Now on to the ‘cast
07/03/2025

EMCrit 396 - Some Philosophy of Surgical Airways (Crics) and What to Do When the Doom is Lower Down (Central Airway Obstruction)

EMCrit FOAM Feed
01/03/2009

EMCrit Podcast 0 – The Intro

In which I introduce you to me and explain what this whole thing is about. (better late than never)
29 mars

EMCrit 422 - SSC 2026 Guidelines: The good, the Bad, and the UGLY

EMCrit FOAM Feed
18/09/2019

EMCrit 256 – RUSH Redux with Jacob Avila

Some dozen years ago, a couple of my buddies and I created the RUSH exam. Today, I give you an update:
30/12/2021

EMCrit 314 - Shadowboxing Ep.1 (Free for Learners of all Ilks)

.

EMCrit Podcast and Friends!