The treatment of Acute Ischemic Stroke is a rapidly evolving field with critical care transport medicine playing an increasing role in the treatment of these patients. Dr. Irankunda explores CCTM specific management and historical musts when treating this unique patient population. Dr. Gottula provides a brief review of the literature supporting IV alteplase and endovascular thrombectomy.
Read MoreHypokalemia is a commonly seen laboratory abnormality which is often unappreciated in the emergency department. Join us as we take a deep dive into the presentation and life threatening consequences of a patient with severe hypokalemia as we review a previous case from an international leader in critical care transport medicine, Air Care.
Read MoreNo Lung? No problem! Join Liz Powell, Paige Barger and Adam Gottula as they take a look at the basics of VV ECMO in the transport environment.
Read MoreWhile high-quality CPR delivers the best outcomes in cardiac arrest, this is challenging in a transport environment. Dr. Connelly reviews the evidence behind mechanical chest compression in CPR, exploring its practicality to the Helicopter EMS (HEMS) environment.
Read MoreDamage Control Resuscitation, Permissive Hypotension, Fluid Restrictive Resuscitation… Regardless of name, with all the enthusiasm surrounding permissive hypotension in the actively bleeding trauma patient, what do we do when they have a TBI? Take a dive into the literature surrounding ideal perfusion pressures of patients suffering from TBIs and traumatic injury to find out if we know what pressure is really the best.
Read MoreThis week Dr. Kathryn Banning led us in our first Morbidity and Mortality conference of the year. Dr. Banning led us through robust discussion about concurrent pathology presentations, biases and more. Air Care Grand Rounds followed, in which we reviewed aircraft operations and logistics with the Air Care team and went through a simulation case that highlighted the importance of stress inoculation.
Read MoreNot every bradycardic patient is the same, however sometimes their past history gives away their pathology and you need to manage a complex disease in the ED or in transit to the ICU. Remind yourself of the details of the cardiac action potential as Dr. Roblee walks us through a unique case of Long QT Syndrome.
Read MoreWhile often alarming, neonatal resuscitation is critical in the care of a neonate. In the critical care transport environment preparations is crucial in optimizing resuscitation success. In this edition of Air Care Series, Dr. Irankunda walks us through neonatal resuscitation in the transport environment.
Read MoreIn this edition of the Air Care series we take a look at the LVAD via post and podcast, introducing you to the meeting of man and machine. Adam Gottula, MD interviews Liz Powell, MD and Paige Barger, NP covering the spectrum of LVAD basics from common functions to life threatening complications.
Read MoreShan Modi, MD walks us through a critically ill patient with pulmonary embolism then breaks down the literature surrounding the management of Pulmonary Embolism both in the Emergency Department and Critical Care Transport Environment. We will cover fluid support, vasopressor usage, ventilatory management, vasodilators, ECMO and more!
Read MoreKatherine Connelly, MD reviews the literature surrounding the definition and management of sepsis both in the Emergency Department and Critical Care Transport Environment. We will cover pressor usage, as well as appropriate antibiotic coverage and if there is any role for steroids (for now…)
Read MoreSeverely burned patients can be intimidating for even the most seasoned critical care transport providers. These patients often require aggressive resuscitation and multiple procedures in a relatively short period of time. It is often easy for providers to become overwhelmed, necessitating an algorithmic approach to the patient, similar to traumatically injured patients, is crucial. By advancing through the primary survey and stabilizing the patient while starting aggressive but goal directed crystalloid resuscitation, critical care transport providers can bring ICU level care to one of the sickest pre-hospital patient populations.
Read MoreIn HEMS, there are rare instances where ‘stay and play’ is the safest thing for the patient. Exsanguinating variceal bleed is one of those conditions. This week Dr. Whitford takes us step-by-step through the placement and confirmation of balloon tamponade placement (Minnesota Tube) for stabilization of these bleeds. We hope by reading this, it gives you another 6 months of this not happening on your next transport or ED shift...
Read MoreCardiogenic shock presents many challenges in both the transport environment and hospital setting. We aim to review the current state of evidence pertaining to the medical management in the critical care transport environment.
Read MoreNot many aspects of Emergency Medicine define our specialty better than resuscitation, and few concepts exemplify resuscitation better than shock and intubation. Yet few words together strike greater fear in the minds of savvy resuscitationists. Not because we cannot deftly manage shock, or because we are anything but hardy intubators, but because the swiftest way to transform a living patient into a dying patient or a dying patient into a dead patient is to brazenly intubate someone who is in shock. What are the root causes of endotracheal intubation's (ETI) hemodynamic effects and, most importantly, how do we circumnavigate them? Read on to learn how to safely intubate the patient in shock…
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
