@IM_Crit_
@imcrit.bsky.social
Intensivist I Internal Medicine | ☕️, 🍩, 🥐, 🍫 addict |
#emimcc
#emimcc
Merry Christmas to all those celebrating!
December 25, 2025 at 2:33 PM
Merry Christmas to all those celebrating!
Reposted by @IM_Crit_
Holiday gift for ya: the IBCC chatbot app 😁
Free AI chatbot searches IBCC contents
Answers seem pretty good & it links to relevent chapters for additional info
Works as an Ebook index on steroids
Created by emergency med folks at Columbia (credit to Joshua Farber & David Fisher) #EMIMCC
Free AI chatbot searches IBCC contents
Answers seem pretty good & it links to relevent chapters for additional info
Works as an Ebook index on steroids
Created by emergency med folks at Columbia (credit to Joshua Farber & David Fisher) #EMIMCC
December 24, 2025 at 2:52 PM
Holiday gift for ya: the IBCC chatbot app 😁
Free AI chatbot searches IBCC contents
Answers seem pretty good & it links to relevent chapters for additional info
Works as an Ebook index on steroids
Created by emergency med folks at Columbia (credit to Joshua Farber & David Fisher) #EMIMCC
Free AI chatbot searches IBCC contents
Answers seem pretty good & it links to relevent chapters for additional info
Works as an Ebook index on steroids
Created by emergency med folks at Columbia (credit to Joshua Farber & David Fisher) #EMIMCC
Christmas is just around the corner (👏 to the creator of this 👇)
December 24, 2025 at 3:29 AM
Christmas is just around the corner (👏 to the creator of this 👇)
Reposted by @IM_Crit_
Scalpel-Finger-Bougie Cric
-Large, midline vertical incision
-Palpate cricothyroid membrane w/ finger of nondominant hand
-Scalpel through membrane, drag laterally, flip and drag laterally
-Scalpel out, finger in
-Bougie in guided by finger
-6-0 ETT over bougie
youtube.com/shorts/jB3vq...
#EMIMCC
-Large, midline vertical incision
-Palpate cricothyroid membrane w/ finger of nondominant hand
-Scalpel through membrane, drag laterally, flip and drag laterally
-Scalpel out, finger in
-Bougie in guided by finger
-6-0 ETT over bougie
youtube.com/shorts/jB3vq...
#EMIMCC
Deliberate Practice: Cric #criticalcare #emergencymedicine #airway
YouTube video by EMSwami
youtube.com
December 22, 2025 at 2:32 PM
Scalpel-Finger-Bougie Cric
-Large, midline vertical incision
-Palpate cricothyroid membrane w/ finger of nondominant hand
-Scalpel through membrane, drag laterally, flip and drag laterally
-Scalpel out, finger in
-Bougie in guided by finger
-6-0 ETT over bougie
youtube.com/shorts/jB3vq...
#EMIMCC
-Large, midline vertical incision
-Palpate cricothyroid membrane w/ finger of nondominant hand
-Scalpel through membrane, drag laterally, flip and drag laterally
-Scalpel out, finger in
-Bougie in guided by finger
-6-0 ETT over bougie
youtube.com/shorts/jB3vq...
#EMIMCC
I am quite sure that this type of aggressive marketing will not be effective in my case…
December 22, 2025 at 2:13 AM
I am quite sure that this type of aggressive marketing will not be effective in my case…
Given the expanding range of conditions for which Ozempic and Wegovy are being investigated (from obesity to dementia), has anybody evaluated them for the treatment of sepsis?
#MedSky
#MedSky
December 21, 2025 at 3:57 PM
Given the expanding range of conditions for which Ozempic and Wegovy are being investigated (from obesity to dementia), has anybody evaluated them for the treatment of sepsis?
#MedSky
#MedSky
December 14, 2025 at 7:28 PM
Reposted by @IM_Crit_
🔥Fresh blog🔥 Hot take on RSI trial of ketamine vs etomidate
RSI & EvK trials both show *more* BP instability with ketamine *but* lower mortality with ketamine 🤔
Cause of BP drops with ketamine?
- Less pressor pre-intubation?
- Ketamine provides analgesia (eliminating pain-as-a-pressor)?
... #1/2
RSI & EvK trials both show *more* BP instability with ketamine *but* lower mortality with ketamine 🤔
Cause of BP drops with ketamine?
- Less pressor pre-intubation?
- Ketamine provides analgesia (eliminating pain-as-a-pressor)?
... #1/2
December 10, 2025 at 4:00 PM
🔥Fresh blog🔥 Hot take on RSI trial of ketamine vs etomidate
RSI & EvK trials both show *more* BP instability with ketamine *but* lower mortality with ketamine 🤔
Cause of BP drops with ketamine?
- Less pressor pre-intubation?
- Ketamine provides analgesia (eliminating pain-as-a-pressor)?
... #1/2
RSI & EvK trials both show *more* BP instability with ketamine *but* lower mortality with ketamine 🤔
Cause of BP drops with ketamine?
- Less pressor pre-intubation?
- Ketamine provides analgesia (eliminating pain-as-a-pressor)?
... #1/2
The fetishization of #albumin is perpetuated by persistent misconceptions & entrenched beliefs among both nurses & physicians
A new graduate nurse (still working under supervision and alongside a preceptor) just asked me if I want to give albumin to his pt who is still on norepi
A new graduate nurse (still working under supervision and alongside a preceptor) just asked me if I want to give albumin to his pt who is still on norepi
December 9, 2025 at 9:50 PM
The fetishization of #albumin is perpetuated by persistent misconceptions & entrenched beliefs among both nurses & physicians
A new graduate nurse (still working under supervision and alongside a preceptor) just asked me if I want to give albumin to his pt who is still on norepi
A new graduate nurse (still working under supervision and alongside a preceptor) just asked me if I want to give albumin to his pt who is still on norepi
#ICU Quiz:
Day #2 of mechanical ventilation. A patient with ARDS has a plateau pressure of 25 on a PEEP of 5 (VCV; Vt 7 ml/kg). Comfortable - synchrony with the vent - ABGs: "OK".
Would you decrease the tidal volume to bring the driving pressure closer to 15?
Yes?
No?
Day #2 of mechanical ventilation. A patient with ARDS has a plateau pressure of 25 on a PEEP of 5 (VCV; Vt 7 ml/kg). Comfortable - synchrony with the vent - ABGs: "OK".
Would you decrease the tidal volume to bring the driving pressure closer to 15?
Yes?
No?
December 8, 2025 at 3:13 AM
#ICU Quiz:
Day #2 of mechanical ventilation. A patient with ARDS has a plateau pressure of 25 on a PEEP of 5 (VCV; Vt 7 ml/kg). Comfortable - synchrony with the vent - ABGs: "OK".
Would you decrease the tidal volume to bring the driving pressure closer to 15?
Yes?
No?
Day #2 of mechanical ventilation. A patient with ARDS has a plateau pressure of 25 on a PEEP of 5 (VCV; Vt 7 ml/kg). Comfortable - synchrony with the vent - ABGs: "OK".
Would you decrease the tidal volume to bring the driving pressure closer to 15?
Yes?
No?
CDC advisory panel votes to limit hepatitis B vaccines for newborns
Fun fact: HBV can be spread by household objects (toothbrushes, razors) used by an infected person. Only ~50% of cases before 1991 were a result of transmission from an infected mother
www.theguardian.com/us-news/2025...
Fun fact: HBV can be spread by household objects (toothbrushes, razors) used by an infected person. Only ~50% of cases before 1991 were a result of transmission from an infected mother
www.theguardian.com/us-news/2025...
CDC advisory panel votes to limit hepatitis B vaccines for newborns
Move from RFK Jr’s advisers mirrors Trump team’s regressive approach to longstanding vaccine guidance
www.theguardian.com
December 5, 2025 at 4:28 PM
CDC advisory panel votes to limit hepatitis B vaccines for newborns
Fun fact: HBV can be spread by household objects (toothbrushes, razors) used by an infected person. Only ~50% of cases before 1991 were a result of transmission from an infected mother
www.theguardian.com/us-news/2025...
Fun fact: HBV can be spread by household objects (toothbrushes, razors) used by an infected person. Only ~50% of cases before 1991 were a result of transmission from an infected mother
www.theguardian.com/us-news/2025...
It took us a while to recognize euglycemic diabetic ketoacidosis (euDKA) in patients treated with Na-glucose cotransporter-2 inhibitors. It seems that we may have to be on the lookout for euDKA in patients treated with glucagon-like peptide-1 receptor agonists (#Ozempic #Zepbound)
December 2, 2025 at 10:40 PM
It took us a while to recognize euglycemic diabetic ketoacidosis (euDKA) in patients treated with Na-glucose cotransporter-2 inhibitors. It seems that we may have to be on the lookout for euDKA in patients treated with glucagon-like peptide-1 receptor agonists (#Ozempic #Zepbound)
Crash course in hemodynamics:
November 29, 2025 at 9:45 PM
Crash course in hemodynamics:
Reposted by @IM_Crit_
updated the acute liver failure chapter
biggest change is increasing support for early CRRT to remove NH3 (to reduce elevated intracranial pressure)
now rec'd for clinically overt encephalopathy (Grade 2-4)
if admitting to ICU for ALF & encephalopathy, just dialyze
emcrit.org/ibcc/alf/ #EMIMCC
biggest change is increasing support for early CRRT to remove NH3 (to reduce elevated intracranial pressure)
now rec'd for clinically overt encephalopathy (Grade 2-4)
if admitting to ICU for ALF & encephalopathy, just dialyze
emcrit.org/ibcc/alf/ #EMIMCC
November 28, 2025 at 1:51 PM
updated the acute liver failure chapter
biggest change is increasing support for early CRRT to remove NH3 (to reduce elevated intracranial pressure)
now rec'd for clinically overt encephalopathy (Grade 2-4)
if admitting to ICU for ALF & encephalopathy, just dialyze
emcrit.org/ibcc/alf/ #EMIMCC
biggest change is increasing support for early CRRT to remove NH3 (to reduce elevated intracranial pressure)
now rec'd for clinically overt encephalopathy (Grade 2-4)
if admitting to ICU for ALF & encephalopathy, just dialyze
emcrit.org/ibcc/alf/ #EMIMCC
If you remain unconvinced regarding the extent of inefficiency & resource waste within US health care, please read this:
Today, I admitted to the ICU a pt in etoh withdrawal who was transported by helicopter —a 10min flight— solely for being on Precedex (dexmedetomidine) infusion at 0.2 mcg/kg/min
Today, I admitted to the ICU a pt in etoh withdrawal who was transported by helicopter —a 10min flight— solely for being on Precedex (dexmedetomidine) infusion at 0.2 mcg/kg/min
November 28, 2025 at 7:47 PM
If you remain unconvinced regarding the extent of inefficiency & resource waste within US health care, please read this:
Today, I admitted to the ICU a pt in etoh withdrawal who was transported by helicopter —a 10min flight— solely for being on Precedex (dexmedetomidine) infusion at 0.2 mcg/kg/min
Today, I admitted to the ICU a pt in etoh withdrawal who was transported by helicopter —a 10min flight— solely for being on Precedex (dexmedetomidine) infusion at 0.2 mcg/kg/min
Reposted by @IM_Crit_
Ethical review of brain death in the context of familial objections or pregnancy.
This is largely intuitive and common sense, but it's useful to have a guideline if needed for reference. #EMIMCC
www.neurology.org/doi/pdf/10.1...
This is largely intuitive and common sense, but it's useful to have a guideline if needed for reference. #EMIMCC
www.neurology.org/doi/pdf/10.1...
Brain Death/Death by Neurologic Criteria Guidance on Communication, Objections, Pregnancy, and Public Trust | Neurology
This position statement provides updated member guidance from the American Academy
of Neurology (AAN) regarding (1) communication with surrogate decision makers about
brain death/death by neurologic c...
www.neurology.org
November 21, 2025 at 11:25 PM
Ethical review of brain death in the context of familial objections or pregnancy.
This is largely intuitive and common sense, but it's useful to have a guideline if needed for reference. #EMIMCC
www.neurology.org/doi/pdf/10.1...
This is largely intuitive and common sense, but it's useful to have a guideline if needed for reference. #EMIMCC
www.neurology.org/doi/pdf/10.1...
There are plenty of sodium bicarbonate haters (😊) in the Critical Care & ED world
But what will they say now that an RCT on patients with acute peripheral vertigo found combo therapy with diphenhydramine (Benadryl) provided better symptom relief than diphenhydramine alone?
#foamed #meded #Medsky
But what will they say now that an RCT on patients with acute peripheral vertigo found combo therapy with diphenhydramine (Benadryl) provided better symptom relief than diphenhydramine alone?
#foamed #meded #Medsky
November 20, 2025 at 5:53 AM