New-onset bradycardia?
5 Pathological categories to think about:
- Cardiac: MI (inferior), AV block, SSS
- Neuro: ↑ICP, stroke
- Metabolic: Hypothyroid, hyperkalemia, hypothermia
- Meds: Beta-blocker, digoxin, opioid
- Infectious: myocarditis/endocarditis

Consider subdissociative dose of ketamine (0.3-0.5 mg/kg) for patients in status asthmaticus - may help with air hunger, provide anxiolysis, and facilitate other treatments such as NIPPV and delivery of inhaled/systemic bronchodilators

#medsky #emergencymedicine #criticalcare

⚙️🫀LVAD Initial Assessment (ABCs)
- A: Auscultate hum & vitals (MAP)
- B: Battery check
- C: Controller variables (flow, power)
- D: Driveline - check skin & connection
- E: Echo (LV, RV, pericardial space)

#medsky #criticalcare #fomed #emergencymedicine #resuscitation

Adrenal Crisis

- Chronic Adrenal Insufficiency + Trigger (infection, hypovolemia, trauma)
- Acute (adrenal/pituitary hemorrhage)-uncommon

Clinical Features
- Hypotension
- Hypo/Hyperthermia
- GI symptoms
- Delirium
- Hyponatremia, Hyperkalemia
- Hypoglycemia, NAGMA

#medsky #foamed #criticalcare

Post Cardiac Arrest Priorities:

- Avoid fever
- Adequate sedation & analgesia
- Hemodynamics (MAP >65)
- Lung protective vent settings
- Normoxia & normocapnia
- Identify/treat reversible causes
- Update family/next of kin

#medsky #criticalcare #emergencymedicine #foamed #resuscitation

Underdosing benzodiazepines is a common pitfall in the management of status epilepticus. For adult patients:

- Lorazepam: 4 mg IV per dose
- Midazolam: 10 mg IM if no line
- Diazepam: 10 mg IV per dose

#medsky #criticalcare #emergencymedicine #foamed #resuscitation

35 yo male presenting with palpitations and near syncopal event. Bedside echo - apical 4 chamber view 👇🏼

If a patient is hypokalemic assume they are also hypomagnesemic. Check and replenish magnesium! Hypomagnesemia induces renal potassium wasting, making it hard to correct K+. Reminder: serum Mg ≠ total body Mg—most is intracellular 🧫

#medsky #electrolytes #meded #foamed

🫀Emergency Department Post-Cardiac Arrest Cardiovascular checklist ✅

#medsky #emergencymedicine #criticalcare #meded #foamed #resuscitation

For patients with GIB who are actively bleeding, have a high shock index, and/or LLS, do not base your management on the initial H&H. Drop in hemoglobin can lag and give a false sense of assurance. Resuscitate aggressively #emergencymedicine #resuscitation #FOAMed #blueskymed #medsky