DBP and pulse pressure are somewhat redundant. I added pulse pressure but they will generally trend in opposite directions provided the MAP is held in a somewhat fixed position around 70mm

I guess the evaluation of congestion is kinda assumed... also I wanted to de-emphasize the whole fluids thing

Why didn't you put in the algorhytm pulse pressure (>40) which was a checkpoint in AS-2?

2) in the rest of the chapter I have not seen a section about fluid tolerance (paired with fluid responsiveness which is present)..is there a reason?

One more time thank you for the IBCC, is a thing of beauty

BP control can be achieved w sympatholysis and sedation + positive pressure ventilation. I don't see the urgency of put in the mix any antihypertensive med before intubation and I think it's a very dangerous move. If BP high after tubing lets add some drugs. But come on...is not an aortic rupture

but not in a hurry😉

ED PHEM doc here. I'm using more and more NIV for preox (usually NIV-ST on Hamilton T1). So I'm giving back up breaths on peep during apneic phase. #EMIMCC

4. Probably it s better not to try anything "softer" than intubation. But while preoxygenating I d put him on 10 cmh20 of peep at least

Anyone with similar cases? how did it happen? Just a lack of proper follow up? Some syndromic presentation? It left me kind of unconfortable #EMIMCC is incredibile #FOAMed

AHAHAHAHAHAHAHA

@gx8a.bsky.social tu, midazolam team 🤢

It's entirely possible that bronchodilation is due to the anticholinergic and ketamine isn't doing anything.

Regardless, I've used this combination (high dose ketamine + IV scheduled glycopyrrolate) and like the study shows it seems to work well.

Pending further data this seems reasonable.🤷‍♂️