Anand Swaminathan
@emswami.bsky.social
EM doc | Resuscitationist | Medical Educator | EMRAP Managing Editor
He/Him/His
Instagram: @EMSwami
He/Him/His
Instagram: @EMSwami
Permissive Hypercapnia
-Allows CO2 to rise to avoid breath stacking (pH will stay low too)
-Settings: RR 8-10, I:E ratio w/ long expiratory time
-As meds kick in, will relieve bronchospasm which means less expiratory time needed + can start to blow off CO2
youtube.com/shorts/Xblf7...
#EMIMCC
-Allows CO2 to rise to avoid breath stacking (pH will stay low too)
-Settings: RR 8-10, I:E ratio w/ long expiratory time
-As meds kick in, will relieve bronchospasm which means less expiratory time needed + can start to blow off CO2
youtube.com/shorts/Xblf7...
#EMIMCC
Mechanical Vent in Asthma #criticalcare #emergencymedicine
YouTube video by EMSwami
youtube.com
November 10, 2025 at 3:00 PM
Permissive Hypercapnia
-Allows CO2 to rise to avoid breath stacking (pH will stay low too)
-Settings: RR 8-10, I:E ratio w/ long expiratory time
-As meds kick in, will relieve bronchospasm which means less expiratory time needed + can start to blow off CO2
youtube.com/shorts/Xblf7...
#EMIMCC
-Allows CO2 to rise to avoid breath stacking (pH will stay low too)
-Settings: RR 8-10, I:E ratio w/ long expiratory time
-As meds kick in, will relieve bronchospasm which means less expiratory time needed + can start to blow off CO2
youtube.com/shorts/Xblf7...
#EMIMCC
FAST in Hypotensive Trauma
-Start w/ lung/cardiac windows first
-RUQ (+) - changes next destination for management but no immediate intervention
-Lung (+) (ie PTX) or cardiac (+) (ie tamponade) - immediate intervention (thoracostomy/thoracotomy)
youtube.com/shorts/LKmmo...
#EMIMCC
-Start w/ lung/cardiac windows first
-RUQ (+) - changes next destination for management but no immediate intervention
-Lung (+) (ie PTX) or cardiac (+) (ie tamponade) - immediate intervention (thoracostomy/thoracotomy)
youtube.com/shorts/LKmmo...
#EMIMCC
FAST in Hypotensive Trauma #emergencymedicine #criticalcare #trauma #fast
YouTube video by EMSwami
youtube.com
November 7, 2025 at 10:35 PM
FAST in Hypotensive Trauma
-Start w/ lung/cardiac windows first
-RUQ (+) - changes next destination for management but no immediate intervention
-Lung (+) (ie PTX) or cardiac (+) (ie tamponade) - immediate intervention (thoracostomy/thoracotomy)
youtube.com/shorts/LKmmo...
#EMIMCC
-Start w/ lung/cardiac windows first
-RUQ (+) - changes next destination for management but no immediate intervention
-Lung (+) (ie PTX) or cardiac (+) (ie tamponade) - immediate intervention (thoracostomy/thoracotomy)
youtube.com/shorts/LKmmo...
#EMIMCC
Incr safe apneic time important in improving 1st pass success
-Preox w/ NIV: Incr PaO2, recruit alveoli
-Oxygenate + intubate in Bed Up, Head Elevated
-Apneic O2 w/ flush rate NC
-Use rocuronium instead of succinylcholine (up to 45 sec more safe apneic time)
youtube.com/shorts/-3MFR...
#EMIMCC
-Preox w/ NIV: Incr PaO2, recruit alveoli
-Oxygenate + intubate in Bed Up, Head Elevated
-Apneic O2 w/ flush rate NC
-Use rocuronium instead of succinylcholine (up to 45 sec more safe apneic time)
youtube.com/shorts/-3MFR...
#EMIMCC
Safe Apneic Time #emergencymedicine #criticalcare #intubation #airway
YouTube video by EMSwami
youtube.com
November 5, 2025 at 3:03 PM
Incr safe apneic time important in improving 1st pass success
-Preox w/ NIV: Incr PaO2, recruit alveoli
-Oxygenate + intubate in Bed Up, Head Elevated
-Apneic O2 w/ flush rate NC
-Use rocuronium instead of succinylcholine (up to 45 sec more safe apneic time)
youtube.com/shorts/-3MFR...
#EMIMCC
-Preox w/ NIV: Incr PaO2, recruit alveoli
-Oxygenate + intubate in Bed Up, Head Elevated
-Apneic O2 w/ flush rate NC
-Use rocuronium instead of succinylcholine (up to 45 sec more safe apneic time)
youtube.com/shorts/-3MFR...
#EMIMCC
Endovasc Stroke Tx + Airway
-High risk airway decomp: High NIHSS, AMS or Posterior Stroke
-Etomidate a great agent: HD stable
-Avoid hypocarbia (cerebral vasoconstriction)
-After intubation, lie patient flat. Studies (PMID: 40465238) show improved outcomes
youtube.com/shorts/LChtQ...
#EMIMCC
-High risk airway decomp: High NIHSS, AMS or Posterior Stroke
-Etomidate a great agent: HD stable
-Avoid hypocarbia (cerebral vasoconstriction)
-After intubation, lie patient flat. Studies (PMID: 40465238) show improved outcomes
youtube.com/shorts/LChtQ...
#EMIMCC
Intubating in Large Vessel Occlusion Stroke #emergencymedicine #criticalcare #intubation
YouTube video by EMSwami
youtube.com
November 3, 2025 at 3:02 PM
Endovasc Stroke Tx + Airway
-High risk airway decomp: High NIHSS, AMS or Posterior Stroke
-Etomidate a great agent: HD stable
-Avoid hypocarbia (cerebral vasoconstriction)
-After intubation, lie patient flat. Studies (PMID: 40465238) show improved outcomes
youtube.com/shorts/LChtQ...
#EMIMCC
-High risk airway decomp: High NIHSS, AMS or Posterior Stroke
-Etomidate a great agent: HD stable
-Avoid hypocarbia (cerebral vasoconstriction)
-After intubation, lie patient flat. Studies (PMID: 40465238) show improved outcomes
youtube.com/shorts/LChtQ...
#EMIMCC
VT ECG
-ERAD(down I + aVF)
-V6 dominant S wave (all electricity from L heart away from ECG lead)
-RS > 100 msec in precordial leads
-QRS > 160 msec and Either no RSR’ in V1 L rabbit ear > right
In real life, if rhythm fast, wide + regular, assume VT + treat as VT
youtube.com/shorts/glxzf...
#EMIMCC
-ERAD(down I + aVF)
-V6 dominant S wave (all electricity from L heart away from ECG lead)
-RS > 100 msec in precordial leads
-QRS > 160 msec and Either no RSR’ in V1 L rabbit ear > right
In real life, if rhythm fast, wide + regular, assume VT + treat as VT
youtube.com/shorts/glxzf...
#EMIMCC
VTach ECG Features #emergencymedicine #criticalcare #cardiology #resuscitation
YouTube video by EMSwami
youtube.com
October 31, 2025 at 2:15 PM
VT ECG
-ERAD(down I + aVF)
-V6 dominant S wave (all electricity from L heart away from ECG lead)
-RS > 100 msec in precordial leads
-QRS > 160 msec and Either no RSR’ in V1 L rabbit ear > right
In real life, if rhythm fast, wide + regular, assume VT + treat as VT
youtube.com/shorts/glxzf...
#EMIMCC
-ERAD(down I + aVF)
-V6 dominant S wave (all electricity from L heart away from ECG lead)
-RS > 100 msec in precordial leads
-QRS > 160 msec and Either no RSR’ in V1 L rabbit ear > right
In real life, if rhythm fast, wide + regular, assume VT + treat as VT
youtube.com/shorts/glxzf...
#EMIMCC
Reposted by Anand Swaminathan
MASSIVE RCT from Kenya showing that steroids reduce mortality in CAP
Mortality benefit easier to demonstrate w/ less resources available to salvage pts
Should allay the hype that the negative REMAP-CAP steroid RCT received (despite being woefully underpowered)
www.nejm.org/doi/pdf/10.1... #EMIMCC
Mortality benefit easier to demonstrate w/ less resources available to salvage pts
Should allay the hype that the negative REMAP-CAP steroid RCT received (despite being woefully underpowered)
www.nejm.org/doi/pdf/10.1... #EMIMCC
October 29, 2025 at 3:37 PM
MASSIVE RCT from Kenya showing that steroids reduce mortality in CAP
Mortality benefit easier to demonstrate w/ less resources available to salvage pts
Should allay the hype that the negative REMAP-CAP steroid RCT received (despite being woefully underpowered)
www.nejm.org/doi/pdf/10.1... #EMIMCC
Mortality benefit easier to demonstrate w/ less resources available to salvage pts
Should allay the hype that the negative REMAP-CAP steroid RCT received (despite being woefully underpowered)
www.nejm.org/doi/pdf/10.1... #EMIMCC
Reposted by Anand Swaminathan
New RCT: Avoiding A-line in shock didn't affect mortality (trend towards *reduction*) & decreased line complications
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
October 29, 2025 at 3:19 PM
New RCT: Avoiding A-line in shock didn't affect mortality (trend towards *reduction*) & decreased line complications
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
Chest Tube Irrigation After Hemothorax Drainage
-Accumulating evidence shows reduction in complications (reaccumulation, effusions, empyema) PMID: 38764139
-Easy to do: place tube, drain blood, instill 500 cc of NS and suction out
-Can repeat 1-2 times
youtube.com/shorts/QhpAN...
#EMIMCC
-Accumulating evidence shows reduction in complications (reaccumulation, effusions, empyema) PMID: 38764139
-Easy to do: place tube, drain blood, instill 500 cc of NS and suction out
-Can repeat 1-2 times
youtube.com/shorts/QhpAN...
#EMIMCC
Chest Tube Irrigation #emergencymedicine #criticalcare #trauma
YouTube video by EMSwami
youtube.com
October 29, 2025 at 1:31 PM
Chest Tube Irrigation After Hemothorax Drainage
-Accumulating evidence shows reduction in complications (reaccumulation, effusions, empyema) PMID: 38764139
-Easy to do: place tube, drain blood, instill 500 cc of NS and suction out
-Can repeat 1-2 times
youtube.com/shorts/QhpAN...
#EMIMCC
-Accumulating evidence shows reduction in complications (reaccumulation, effusions, empyema) PMID: 38764139
-Easy to do: place tube, drain blood, instill 500 cc of NS and suction out
-Can repeat 1-2 times
youtube.com/shorts/QhpAN...
#EMIMCC
Intubating in elevated ICP
-BP control w/ clevidipine/nicardipine
-Fentanyl: blunt catechol response
-Osmotic agents: 30 cc of 23.4% hypertonic
-Etomidate + rocuronium (no fasciculations, longer safe apneic time)
-Sedation/analgesia ready(bucking tube spikes ICP)
youtube.com/shorts/747a9...
#EMIMCC
-BP control w/ clevidipine/nicardipine
-Fentanyl: blunt catechol response
-Osmotic agents: 30 cc of 23.4% hypertonic
-Etomidate + rocuronium (no fasciculations, longer safe apneic time)
-Sedation/analgesia ready(bucking tube spikes ICP)
youtube.com/shorts/747a9...
#EMIMCC
Intubating Increased ICP #emergencymedicine #criticalcare
YouTube video by EMSwami
youtube.com
October 27, 2025 at 1:35 PM
Intubating in elevated ICP
-BP control w/ clevidipine/nicardipine
-Fentanyl: blunt catechol response
-Osmotic agents: 30 cc of 23.4% hypertonic
-Etomidate + rocuronium (no fasciculations, longer safe apneic time)
-Sedation/analgesia ready(bucking tube spikes ICP)
youtube.com/shorts/747a9...
#EMIMCC
-BP control w/ clevidipine/nicardipine
-Fentanyl: blunt catechol response
-Osmotic agents: 30 cc of 23.4% hypertonic
-Etomidate + rocuronium (no fasciculations, longer safe apneic time)
-Sedation/analgesia ready(bucking tube spikes ICP)
youtube.com/shorts/747a9...
#EMIMCC
Reposted by Anand Swaminathan
Research Roundup (October 2025)
There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs.…
There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs.…
Research Roundup (October 2025)
There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs. AI (Queen of Hearts by PMcardio). Am J Emerg Med. 2025 Jul 30;97:193-199. doi: 10.1016/j.ajem.2025.07.061. Epub ahead of print.
first10em.com
October 27, 2025 at 10:20 AM
Research Roundup (October 2025)
There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs.…
There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs.…
Thyroid storm patients often have high output cardiac failure
-POCUS: LV slamming away more likely to be high output failure
-Beta blockade: slows rate, improves LV filling + cardiac output
-Can use esmolol instead of propranolol as it’s got a short 1/2 life
youtube.com/shorts/Alwol...
#EMIMCC
-POCUS: LV slamming away more likely to be high output failure
-Beta blockade: slows rate, improves LV filling + cardiac output
-Can use esmolol instead of propranolol as it’s got a short 1/2 life
youtube.com/shorts/Alwol...
#EMIMCC
Beta Blockers in Thyroid Storm #emergencymedicine #criticalcare
YouTube video by EMSwami
youtube.com
October 24, 2025 at 1:30 PM
Thyroid storm patients often have high output cardiac failure
-POCUS: LV slamming away more likely to be high output failure
-Beta blockade: slows rate, improves LV filling + cardiac output
-Can use esmolol instead of propranolol as it’s got a short 1/2 life
youtube.com/shorts/Alwol...
#EMIMCC
-POCUS: LV slamming away more likely to be high output failure
-Beta blockade: slows rate, improves LV filling + cardiac output
-Can use esmolol instead of propranolol as it’s got a short 1/2 life
youtube.com/shorts/Alwol...
#EMIMCC
Morrison’s Pouch (RUQ view in FAST)
-Highest yield for finding free fluid
-Must see the liver tip as this is where blood pools first
-Increase sensitivity w/ head down + w/ R lateral decub positioing
youtube.com/shorts/c1Nid...
#EMIMCC
-Highest yield for finding free fluid
-Must see the liver tip as this is where blood pools first
-Increase sensitivity w/ head down + w/ R lateral decub positioing
youtube.com/shorts/c1Nid...
#EMIMCC
Morrison's Pouch in FAST #emergencymedicine #criticalcare #trauma #pocus
YouTube video by EMSwami
youtube.com
October 22, 2025 at 1:46 PM
Morrison’s Pouch (RUQ view in FAST)
-Highest yield for finding free fluid
-Must see the liver tip as this is where blood pools first
-Increase sensitivity w/ head down + w/ R lateral decub positioing
youtube.com/shorts/c1Nid...
#EMIMCC
-Highest yield for finding free fluid
-Must see the liver tip as this is where blood pools first
-Increase sensitivity w/ head down + w/ R lateral decub positioing
youtube.com/shorts/c1Nid...
#EMIMCC
Reposted by Anand Swaminathan
hard cosign on this👇
Also, for patients at risk of aspiration, it's often wise to intubate in a bolt upright position
This was difficult with direct laryngoscopy, but with indirect video-laryngoscopy, it's not hard to intubate patients who are steeply angulated
(you may need to stand on a stool)
Also, for patients at risk of aspiration, it's often wise to intubate in a bolt upright position
This was difficult with direct laryngoscopy, but with indirect video-laryngoscopy, it's not hard to intubate patients who are steeply angulated
(you may need to stand on a stool)
Bed-Up-Head-Elevated (BUHE) positioning is an easy, effective way to increase safe apneic time and reduce intubation related complications PMID: 26866753
youtube.com/shorts/BnZz0...
#EMIMCC
youtube.com/shorts/BnZz0...
#EMIMCC
Head of Bed Elevated for Airway Management #emergencymedicine #criticalcare #intubation
YouTube video by EMSwami
youtube.com
October 20, 2025 at 2:52 PM
hard cosign on this👇
Also, for patients at risk of aspiration, it's often wise to intubate in a bolt upright position
This was difficult with direct laryngoscopy, but with indirect video-laryngoscopy, it's not hard to intubate patients who are steeply angulated
(you may need to stand on a stool)
Also, for patients at risk of aspiration, it's often wise to intubate in a bolt upright position
This was difficult with direct laryngoscopy, but with indirect video-laryngoscopy, it's not hard to intubate patients who are steeply angulated
(you may need to stand on a stool)
Bed-Up-Head-Elevated (BUHE) positioning is an easy, effective way to increase safe apneic time and reduce intubation related complications PMID: 26866753
youtube.com/shorts/BnZz0...
#EMIMCC
youtube.com/shorts/BnZz0...
#EMIMCC
Head of Bed Elevated for Airway Management #emergencymedicine #criticalcare #intubation
YouTube video by EMSwami
youtube.com
October 20, 2025 at 1:31 PM
Bed-Up-Head-Elevated (BUHE) positioning is an easy, effective way to increase safe apneic time and reduce intubation related complications PMID: 26866753
youtube.com/shorts/BnZz0...
#EMIMCC
youtube.com/shorts/BnZz0...
#EMIMCC
DKA Tip #3: HypoK the big killer
-All DKA patients total body K depleted
-Some p/w hyperK due to acidosis shifting K
-K < 3.5, replete prior to starting insulin. > 3.5 start insulin + K together
-Skip bolus: no faster resolution of DKA but incr risk of hypoK
youtube.com/shorts/PK_qF...
#EMIMCC
-All DKA patients total body K depleted
-Some p/w hyperK due to acidosis shifting K
-K < 3.5, replete prior to starting insulin. > 3.5 start insulin + K together
-Skip bolus: no faster resolution of DKA but incr risk of hypoK
youtube.com/shorts/PK_qF...
#EMIMCC
HypoK in DKA #emergencymedicine #criticalcare #dka
YouTube video by EMSwami
youtube.com
October 17, 2025 at 1:32 PM
DKA Tip #3: HypoK the big killer
-All DKA patients total body K depleted
-Some p/w hyperK due to acidosis shifting K
-K < 3.5, replete prior to starting insulin. > 3.5 start insulin + K together
-Skip bolus: no faster resolution of DKA but incr risk of hypoK
youtube.com/shorts/PK_qF...
#EMIMCC
-All DKA patients total body K depleted
-Some p/w hyperK due to acidosis shifting K
-K < 3.5, replete prior to starting insulin. > 3.5 start insulin + K together
-Skip bolus: no faster resolution of DKA but incr risk of hypoK
youtube.com/shorts/PK_qF...
#EMIMCC
DKA Tip #2: Urine dip can mislead
-Body produces 3 ketones: acetoacetate, acetone + beta hydroxybutarate (BHB0
-UA only looks for acetoacetate. BHB dominates in early in DKA
-If worried about DKA, get a chem/blood gas for bicarb + pH + serum BHB
youtube.com/shorts/3KnuI...
#EMIMCC
-Body produces 3 ketones: acetoacetate, acetone + beta hydroxybutarate (BHB0
-UA only looks for acetoacetate. BHB dominates in early in DKA
-If worried about DKA, get a chem/blood gas for bicarb + pH + serum BHB
youtube.com/shorts/3KnuI...
#EMIMCC
Ketones in DKA #emergencymedicine #criticalcare #dka
YouTube video by EMSwami
youtube.com
October 15, 2025 at 3:33 PM
DKA Tip #2: Urine dip can mislead
-Body produces 3 ketones: acetoacetate, acetone + beta hydroxybutarate (BHB0
-UA only looks for acetoacetate. BHB dominates in early in DKA
-If worried about DKA, get a chem/blood gas for bicarb + pH + serum BHB
youtube.com/shorts/3KnuI...
#EMIMCC
-Body produces 3 ketones: acetoacetate, acetone + beta hydroxybutarate (BHB0
-UA only looks for acetoacetate. BHB dominates in early in DKA
-If worried about DKA, get a chem/blood gas for bicarb + pH + serum BHB
youtube.com/shorts/3KnuI...
#EMIMCC
Role of insulin in DKA isn’t to drop sugar, it’s to shut of ketogenesis + close AG
-Don't stop insulin just because glucose hits 250 mg/dl
-Stop when AG closes, acidosis mainly resolved (bicarb greater than 18), long acting insulin on board + glucose controlled
youtube.com/shorts/z7prN...
#EMIMCC
-Don't stop insulin just because glucose hits 250 mg/dl
-Stop when AG closes, acidosis mainly resolved (bicarb greater than 18), long acting insulin on board + glucose controlled
youtube.com/shorts/z7prN...
#EMIMCC
Insulin in DKA #emergencymedicine #criticalcare #dka
YouTube video by EMSwami
youtube.com
October 13, 2025 at 1:40 PM
Role of insulin in DKA isn’t to drop sugar, it’s to shut of ketogenesis + close AG
-Don't stop insulin just because glucose hits 250 mg/dl
-Stop when AG closes, acidosis mainly resolved (bicarb greater than 18), long acting insulin on board + glucose controlled
youtube.com/shorts/z7prN...
#EMIMCC
-Don't stop insulin just because glucose hits 250 mg/dl
-Stop when AG closes, acidosis mainly resolved (bicarb greater than 18), long acting insulin on board + glucose controlled
youtube.com/shorts/z7prN...
#EMIMCC
SVT Diagnosis + Management
-Narrow, exquisitely regular w/ absence of p waves
-Routine Tn not required - results in incr downstream testing w/o improving outcomes
-Skip adenosine + go w/ diltiazem 0.15 mg/kg -
equal success rate, better tolerated, less recurrence
youtube.com/shorts/gghX9...
#EMIMCC
-Narrow, exquisitely regular w/ absence of p waves
-Routine Tn not required - results in incr downstream testing w/o improving outcomes
-Skip adenosine + go w/ diltiazem 0.15 mg/kg -
equal success rate, better tolerated, less recurrence
youtube.com/shorts/gghX9...
#EMIMCC
youtube.com
October 10, 2025 at 1:35 PM
SVT Diagnosis + Management
-Narrow, exquisitely regular w/ absence of p waves
-Routine Tn not required - results in incr downstream testing w/o improving outcomes
-Skip adenosine + go w/ diltiazem 0.15 mg/kg -
equal success rate, better tolerated, less recurrence
youtube.com/shorts/gghX9...
#EMIMCC
-Narrow, exquisitely regular w/ absence of p waves
-Routine Tn not required - results in incr downstream testing w/o improving outcomes
-Skip adenosine + go w/ diltiazem 0.15 mg/kg -
equal success rate, better tolerated, less recurrence
youtube.com/shorts/gghX9...
#EMIMCC
Early defibrillation + high-quality CPR improve OHCA outcomes
-Key is to maximize compression fraction
-Poor defibrillation coordination can eat at your hands on time
-Precharging defib reduces hands off time + increases compression fraction
youtube.com/shorts/y_j2w...
#EMIMCC
-Key is to maximize compression fraction
-Poor defibrillation coordination can eat at your hands on time
-Precharging defib reduces hands off time + increases compression fraction
youtube.com/shorts/y_j2w...
#EMIMCC
Precharging the Defibrillator #emergencymedicine #criticalcare #cardiacarrest #resuscitaiton
YouTube video by EMSwami
youtube.com
October 8, 2025 at 3:17 PM
Early defibrillation + high-quality CPR improve OHCA outcomes
-Key is to maximize compression fraction
-Poor defibrillation coordination can eat at your hands on time
-Precharging defib reduces hands off time + increases compression fraction
youtube.com/shorts/y_j2w...
#EMIMCC
-Key is to maximize compression fraction
-Poor defibrillation coordination can eat at your hands on time
-Precharging defib reduces hands off time + increases compression fraction
youtube.com/shorts/y_j2w...
#EMIMCC
Suction Assisted Laryngoscopy for Airway Decontamination (SALAD) solves the challenge of the soiled airway by maintaining continuous suctioning during airway securing attempts.
1) Overhand grip of suction
2) Lead w/ suction catheter
3) Park suction in esophagus
youtube.com/shorts/vpvmy...
#EMIMCC
1) Overhand grip of suction
2) Lead w/ suction catheter
3) Park suction in esophagus
youtube.com/shorts/vpvmy...
#EMIMCC
SALAD Technique #emergencymedicine #criticalcare #intubation
YouTube video by EMSwami
youtube.com
October 6, 2025 at 11:07 PM
Suction Assisted Laryngoscopy for Airway Decontamination (SALAD) solves the challenge of the soiled airway by maintaining continuous suctioning during airway securing attempts.
1) Overhand grip of suction
2) Lead w/ suction catheter
3) Park suction in esophagus
youtube.com/shorts/vpvmy...
#EMIMCC
1) Overhand grip of suction
2) Lead w/ suction catheter
3) Park suction in esophagus
youtube.com/shorts/vpvmy...
#EMIMCC
Blunt Cardiac Injury
Suspect: blunt traumatic hemothorax, pulmonary contusions, esophageal/aortic injury
Not assoc w/ isolated sternal fracture
w/u: Tn and ECG - If either abnormal, admit to tele and get a comprehensive echo looking for wall motion abnormality
youtube.com/shorts/UTHbm...
#EMIMCC
Suspect: blunt traumatic hemothorax, pulmonary contusions, esophageal/aortic injury
Not assoc w/ isolated sternal fracture
w/u: Tn and ECG - If either abnormal, admit to tele and get a comprehensive echo looking for wall motion abnormality
youtube.com/shorts/UTHbm...
#EMIMCC
Blunt Cardiac Injury #emergencymedicine #criticalcare #trauma
YouTube video by EMSwami
youtube.com
October 3, 2025 at 2:05 PM
Blunt Cardiac Injury
Suspect: blunt traumatic hemothorax, pulmonary contusions, esophageal/aortic injury
Not assoc w/ isolated sternal fracture
w/u: Tn and ECG - If either abnormal, admit to tele and get a comprehensive echo looking for wall motion abnormality
youtube.com/shorts/UTHbm...
#EMIMCC
Suspect: blunt traumatic hemothorax, pulmonary contusions, esophageal/aortic injury
Not assoc w/ isolated sternal fracture
w/u: Tn and ECG - If either abnormal, admit to tele and get a comprehensive echo looking for wall motion abnormality
youtube.com/shorts/UTHbm...
#EMIMCC
IV insulin is a backbone tx in hyperK
Standard: 10 units IVP w/ dextrose
2021 meta(PMID: 33993515) looked at 10 units vs < 10 units
No difference in reduction in serum K.
Reduced risk of hypoglycemic + severe hypoglycemic events w/ reduced insulin dose
youtube.com/shorts/Sz9Zy...
#EMIMCC
Standard: 10 units IVP w/ dextrose
2021 meta(PMID: 33993515) looked at 10 units vs < 10 units
No difference in reduction in serum K.
Reduced risk of hypoglycemic + severe hypoglycemic events w/ reduced insulin dose
youtube.com/shorts/Sz9Zy...
#EMIMCC
Reduced Dose Insulin in HyperK #emergencymedicine #criticalcare
YouTube video by EMSwami
youtube.com
October 1, 2025 at 1:51 PM
IV insulin is a backbone tx in hyperK
Standard: 10 units IVP w/ dextrose
2021 meta(PMID: 33993515) looked at 10 units vs < 10 units
No difference in reduction in serum K.
Reduced risk of hypoglycemic + severe hypoglycemic events w/ reduced insulin dose
youtube.com/shorts/Sz9Zy...
#EMIMCC
Standard: 10 units IVP w/ dextrose
2021 meta(PMID: 33993515) looked at 10 units vs < 10 units
No difference in reduction in serum K.
Reduced risk of hypoglycemic + severe hypoglycemic events w/ reduced insulin dose
youtube.com/shorts/Sz9Zy...
#EMIMCC
Finger-Scalpel-Bougie Approach to Cric
-If you're doing emergency airway management, you MUST be comfortable doing a cric
-Key w/ cric: have a simple approach + practice
-Don’t waste time w/ needle based approaches - they are more likely to fail
youtube.com/shorts/8fDsT...
#EMIMCC
-If you're doing emergency airway management, you MUST be comfortable doing a cric
-Key w/ cric: have a simple approach + practice
-Don’t waste time w/ needle based approaches - they are more likely to fail
youtube.com/shorts/8fDsT...
#EMIMCC
Cric Practice #emergencymedicine #criticalcare #intubation #airway
YouTube video by EMSwami
youtube.com
September 29, 2025 at 1:50 PM
Finger-Scalpel-Bougie Approach to Cric
-If you're doing emergency airway management, you MUST be comfortable doing a cric
-Key w/ cric: have a simple approach + practice
-Don’t waste time w/ needle based approaches - they are more likely to fail
youtube.com/shorts/8fDsT...
#EMIMCC
-If you're doing emergency airway management, you MUST be comfortable doing a cric
-Key w/ cric: have a simple approach + practice
-Don’t waste time w/ needle based approaches - they are more likely to fail
youtube.com/shorts/8fDsT...
#EMIMCC
Diagnosing Pericarditis:
-Pericardium is electrocardiographically silent
-Pericarditis w/ ECG changes = pericarditis w/ epicarditis or pericarditis w/ myocarditis.
-If troponin markedly elevated, trending up or patient looks toxic, admit to workup myocarditis
youtube.com/shorts/jI6Zp...
#EMIMCC
-Pericardium is electrocardiographically silent
-Pericarditis w/ ECG changes = pericarditis w/ epicarditis or pericarditis w/ myocarditis.
-If troponin markedly elevated, trending up or patient looks toxic, admit to workup myocarditis
youtube.com/shorts/jI6Zp...
#EMIMCC
Pericarditis and ECG Changes #emergencymedicine #criticalcare #cardiology
YouTube video by EMSwami
youtube.com
September 26, 2025 at 1:39 PM
Diagnosing Pericarditis:
-Pericardium is electrocardiographically silent
-Pericarditis w/ ECG changes = pericarditis w/ epicarditis or pericarditis w/ myocarditis.
-If troponin markedly elevated, trending up or patient looks toxic, admit to workup myocarditis
youtube.com/shorts/jI6Zp...
#EMIMCC
-Pericardium is electrocardiographically silent
-Pericarditis w/ ECG changes = pericarditis w/ epicarditis or pericarditis w/ myocarditis.
-If troponin markedly elevated, trending up or patient looks toxic, admit to workup myocarditis
youtube.com/shorts/jI6Zp...
#EMIMCC
Replace blood w/ blood
-No role for crystalloid in resus of a shocky trauma patient - dlutes hgb + clotting factors
-What if no blood?
1) Transport
2) Stop bleeding: tourniquet, direct pressure, pelvic binder
3) Tolerate lower BP + consider vasopressors
youtube.com/shorts/u0J9i...
#EMIMCC
-No role for crystalloid in resus of a shocky trauma patient - dlutes hgb + clotting factors
-What if no blood?
1) Transport
2) Stop bleeding: tourniquet, direct pressure, pelvic binder
3) Tolerate lower BP + consider vasopressors
youtube.com/shorts/u0J9i...
#EMIMCC
Replace Blood With Blood #emergencymedicine #criticalcare #trauma
YouTube video by EMSwami
youtube.com
September 24, 2025 at 2:01 PM
Replace blood w/ blood
-No role for crystalloid in resus of a shocky trauma patient - dlutes hgb + clotting factors
-What if no blood?
1) Transport
2) Stop bleeding: tourniquet, direct pressure, pelvic binder
3) Tolerate lower BP + consider vasopressors
youtube.com/shorts/u0J9i...
#EMIMCC
-No role for crystalloid in resus of a shocky trauma patient - dlutes hgb + clotting factors
-What if no blood?
1) Transport
2) Stop bleeding: tourniquet, direct pressure, pelvic binder
3) Tolerate lower BP + consider vasopressors
youtube.com/shorts/u0J9i...
#EMIMCC