Airway management
Judicious use of rapid sequence intubation (RSI) versus awake technique Back-up planning Prioritization of oxygenation Early recognition of failure Early use of surgical technique if necessary Avoidance of ED intubation…
Acute coronary syndrome
Primary etiologies Secondary etiologies Coronary artery spasm Increased myocardial oxygen demand Disruption or erosion of atherosclerotic plaques Reduced myocardial blood flow Platelet aggregation or thrombus formation at the site of…
Massive hemoptysis
Bronchitis Bronchiectasis Aspergilloma Tumor Tuberculosis Lung abscess Emboli Coagulopathy Autoimmune disorders Arterial venous malformation Alveolar hemorrhage Mitral stenosis Pneumonia Presentation Classic presentation Worldwide, tuberculosis (TB) is the most common cause…
Chronic obstructive pulmonary disease
Oxygen Inhaled beta-agonists Inhaled anticholinergics Corticosteroids Antibiotics Noninvasive ventilation Intubation Ventilator management Manage ABCs Patients should be placed on supplemental oxygen therapy as needed to maintain adequate oxygen saturations of…
Upper airway emergencies
Allergic• Anaphylaxis• Angioedema Infectious• Ludwig’s angina• Retropharyngeal abscess/other deep space infections of the neck• Peritonsillar abscess• Epiglottitis Traumatic and caustic• Thermal burn• Traumatic hematoma• Caustic ingestion• Inhaled toxins Anatomical and…
Thoracic trauma
Chest radiography findings concerning for blunt aortic injury Widened mediastinum (>8 cm on supine or >6 cm on upright film) Obscured aortic knob Left apical cap (blood above apex of…
Mechanical ventilation
Strategies of ventilation Outlined below are two ventilation strategies that can be used in critically ill patients in the emergency department. Both of these strategies utilize the assist control (AC)…
Acute spinal cord compression
Neoplastic disease• Most common presentation is metastatic lesion(lung/prostate/breast > renal/gastrointestinal/lymphoma) Mechanical/structural abnormalities• Traumatic/bony injury• Osteoporosis/pathological fracture• Degenerative joint disease• Postsurgical complication Infectious causes• Extradural spinal abscess (IVDU, HIV, tuberculosis, immunosuppression)•…
Status epilepticus
Metabolic Primary central nervous system Toxidromes/toxins • Hypoxia• Hypoglycemia• Hyponatremia• Hypocalcemia• Hypomagnesemia• Inborn errors of metabolism • Trauma• Infections• Cerebral vascular accident• Hemorrhage• Vasculitis• Seizure disorder with other medical condition•…
