Critical Care Perspectives in Emergency Medicine Critical Care Perspectives in Emergency Medicine

REBOA is a relatively new and novel technique that in animal studies has demonstrated benefit in controlling hemorrhage.  However, the evidence for the efficacy of REBOA in humans remains scant.  In this podcast, we discuss the recently published UK-REBOA Trial, which randomized patients to receive REBOA with standard care compared to those randomized to standard care alone.  You may be surprised by these results!

RSI is one of the most common procedures in critically ill patients.  Despite its frequency, there remains significant practice variation on numerous aspects of RSI in the critically ill.  In this podcast, we review pertinent recommendations from the recently published SCCM Guidelines on RSI in the critically ill patient.

Care of the patient with ROSC following OHCA can be complex and typically includes a protocolized approach to optimizing oxygenation, ventilation, hemodynamics, early cardiac catheterization for patients with STEMI, seizure detection, and possibly TTM.  In this podcast, we review two recent articles that focused on the use of mild hypercapnia compared with normocapnia in post arrest patients and the use of a pan-CT protocol to detect critical time sensitive conditions and complications.

Central venous catheter (CVC) placement is common in critically ill patients for a variety of indications.  Thrombocytopenia is also quite common in critically ill patients.  Unfortunately, literature and guideline recommendations vary on the threshold for prophylactic platelet transfusion in patients undergoing a procedure.  In this podcast we discuss a recent trial that evaluated prophylactic platelet transfusion in patients with severe thrombocytopenia undergoing CVC placement.

Over 1 million critically ill patients undergo intubation each year in the United States.  Though direct laryngoscopy remains the most common technique worldwide for intubation, the use of video laryngoscopy has significantly increased.  Studies evaluating video to direct laryngoscopy have thus far produced mixed results.  In this podcast, we review the latest randomized trial, the DEVICE Trial, that assessed video with direct laryngoscopy.  Which device won?

Both etomidate and propofol are commonly used sedative agents in critically ill patients.  Recent literature has suggested that these agents may result in increased harm and mortality.  In this podcast, we discuss the most recent two systematic reviews and meta-analyses that evaluated etomidate and propofol in critically ill patients.  Do we need to change our practice?