EMCrit - IBCC by Josh Farkas https://emcrit.org/ Internet Book of Critical Care Tue, 21 Apr 2026 16:49:16 +0000 en-US hourly 1 https://wordpress.org/?v=6.9.4 https://emcrit.org/feed/podcast/ Scott D. Weingart, MD FCCM no episodic Scott D. Weingart, MD FCCM spambin55@gmail.com 2009- 2009- podcast EMCrit Project http://emcrit.org/wp-content/uploads/powerpress/3000x3000-emcrit.jpg https://emcrit.org 8155655 Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation Nonhepatic hyperammonemia https://emcrit.org/ibcc/nh3/ Fri, 17 Apr 2026 00:13:45 +0000 https://emcrit.org/?post_type=ibcc&p=518730 CONTENTS Intro: Hyperammonemia is a serial killer Clinical presentation & diagnosis Clinical manifestations Neuroimaging Causes Investigation & monitoring Management [1] Neurocritical care of hyperammonemia [2] Reduced enteral ammonia absorption [3] Basic nutritional manipulations [4] Discontinue potentially offensive medications [5] Consider treatment for infectious etiologies [6] Consider zinc supplementation [7] Consider carnitine supplementation [8] Consider additional […]

EMCrit Project by Josh Farkas.

]]> 518730 Critical asthma exacerbation https://emcrit.org/ibcc/asthma/ https://emcrit.org/ibcc/asthma/#respond Sun, 12 Apr 2026 19:38:14 +0000 http://emcrit.org/?post_type=squirt&p=437966 CONTENTS Non-intubated asthmatic management protocol [1] Inhaled bronchodilators [2] Systemic bronchodilators [3] Steroid [4] IV magnesium [5] Volume resuscitation [6a] BiPAP [6b] Sedation to tolerate BiPAP [6c] BiPAP intolerant: HFNC vs. Heliox [7] Monitoring Intubating an asthmatic patient Indications for intubation Procedural details “We're bagging because the vent keeps alarming” Intubated asthmatic management protocol [1] […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/asthma/feed/ 0 437966 Approach an acute focal neurological deficit https://emcrit.org/ibcc/focal-deficit/ Wed, 25 Mar 2026 00:35:41 +0000 https://emcrit.org/?post_type=ibcc&p=507812 CONTENTS History & physical examination Differential diagnosis AIS (acute ischemic stroke) TIA (transient ischemic attack) ICH (intracranial hemorrhage) CVT (cerebral venous thrombosis) PRES / hypertensive crisis viral encephalitis seizure (with post-ictal Todd paralysis) migraine with aura or migraine variant CAA-related transient focal neurologic episodes (TFNEs) recrudescence of a prior focal abnormality functional neurological disorder Evaluation: […]

EMCrit Project by Josh Farkas.

]]> 507812 Headache https://emcrit.org/ibcc/headache/ Thu, 19 Mar 2026 20:00:44 +0000 https://emcrit.org/?post_type=ibcc&p=507743 CONTENTS Headache history & physical examination Headache-focused exam Red flags to elicit in history: [1] 🚩 Meningeal irritation [2] 🚩 ICP elevation [3] 🚩 Vision symptoms [4] 🚩 Systemic inflammation [5] 🚩 Risk factors for ICH [6] 🚩 Thunderclap HA [7] 🚩 Pulsatile tinnitus [8] 🚩 Age >50 YO [9] 🚩 Pregnancy/postpartum Differential diagnosis Secondary […]

EMCrit Project by Josh Farkas.

]]> 507743 Nonconvulsive Status Epilepticus (NCSE) https://emcrit.org/ibcc/ncse/ Tue, 10 Mar 2026 13:56:42 +0000 https://emcrit.org/?post_type=ibcc&p=487729 CONTENTS Clinical presentation(s) Epidemiology and causes of NCSE Clinical manifestations of NCSE & clues Definition of NCSE Antiepileptic trial for ictal/interictal continuum abnormalities Management of NCSE Subtypes of NCSE NCSE with coma Absence NCSE with onset in adulthood Focal NCSE with impaired consciousness Focal NCSE without impaired consciousness Epilepsia Partialis Continua (EPC) common etiologies & […]

EMCrit Project by Josh Farkas.

]]> 487729 Table of Contents https://emcrit.org/ibcc/toc/ https://emcrit.org/ibcc/toc/#respond Sat, 07 Mar 2026 06:22:26 +0000 http://emcrit.org/?post_type=squirt&p=336908 SYSTEMS Cardiology Endocrinology Gastroenterology Hematology & Oncology Infectious diseases Nephrology Neurology Obstetrics Pharmacology Pulmonology Rheumatology Toxicology & Addiction Medicine 🔥Interactive IBCC ChatBot🔥 Overview: Guide to supportive care in critical illness Medication reconciliation in the ICU About this book How to create your own IBCC smartphone app 📲 IBCC ChatBot General Approaches to problems Cardiac arrest […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/toc/feed/ 0 336908 Acute Demyelinating Disorders https://emcrit.org/ibcc/myelin/ Fri, 06 Mar 2026 01:23:53 +0000 https://emcrit.org/?post_type=ibcc&p=489537 CONTENTS Inflammatory demyelinating disorders Acute disseminated encephalomyelitis (ADEM) & acute hemorrhagic leukoencephalitis (AHLE) NMOSD (Neuromyelitis optica spectrum disorders) Multiple sclerosis Myelitis due to multiple sclerosis Tumefactive Multiple Sclerosis Acute Multiple Sclerosis (Marburg variant) Balo concentric sclerosis GFAP-IgG associated myelitis Idiopathic transverse myelitis Management [1] Emergency complications of demyelinating disorders [2] Steroids [3] Plasma exchange vs. […]

EMCrit Project by Josh Farkas.

]]> 489537 Neurologic emergencies in pregnancy https://emcrit.org/ibcc/ob/ Thu, 05 Mar 2026 21:00:34 +0000 https://emcrit.org/?post_type=ibcc&p=487014 CONTENTS General Differential diagnosis Initial approach Specific information about disease states in pregnancy Acute ischemic stroke Seizures (including status epilepticus) Cerebral edema Myasthenia Gravis (MG) Metastatic choriocarcinoma Ventriculoperitoneal shunt malfunction neurological emergencies encountered in pregnancy 💡 Pregnant women presenting with neurologic emergencies can have several simultaneous neuropathologies (especially preeclampsia, PRES, and RCVS). Thus, detection of […]

EMCrit Project by Josh Farkas.

]]> 487014 Spinal Cord https://emcrit.org/ibcc/cord/ Wed, 04 Mar 2026 13:26:21 +0000 https://emcrit.org/?post_type=ibcc&p=487096 CONTENTS spinal cord basics Anatomy Recognizing spinal cord injury Lesion localization Brown-Sequard (hemicord) syndrome Anterior cord syndrome Central cord syndrome Posterior cord syndrome (dorsal columns) & combined degeneration Bowel and bladder symptoms acute & subacute myelopathy Potential causes Investigation Blood tests CSF evaluation Oligoclonal bands IgG index Imaging of the spinal cord Patterns of axial […]

EMCrit Project by Josh Farkas.

]]> 487096 Intermediate & high-risk PE https://emcrit.org/ibcc/pe/ https://emcrit.org/ibcc/pe/#respond Wed, 04 Mar 2026 12:56:16 +0000 http://emcrit.org/?post_type=squirt&p=442020 CONTENTS Crashing PE patient: resuscitation [1] Oxygen maxxing [2] Systemic thrombolysis [3] Epinephrine [4] Vasopressin [5] Inhaled pulmonary vasodilators [6] Preload optimization (volume vs diuresis) [7] Other interventions General approach to PERT activation [1] Investigation package [2] Risk stratification [i] History & physical [ii] Vital signs [iii] Troponin & ECG [iv] Lactate & AG [v] […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/pe/feed/ 0 442020 Pupillometry & pupillary abnormalities https://emcrit.org/ibcc/pupil/ Fri, 20 Feb 2026 22:21:36 +0000 https://emcrit.org/?post_type=ibcc&p=507526 CONTENTS pupillometry Interpretation of parameters Pupil size Constriction% (qPLR) Constriction Velocity (CV) corrected Constriction Velocity (cCV) Dilation Velocity (DV) (Latency) Utilization in specific ICU situations: ICP elevation Supratentorial ICH Malignant MCA syndrome Prognostication after cardiac arrest Pupillary abnormalities during and after seizure Toxic/metabolic coma & effects of medications Toxic/metabolic vs. structural coma Effect of specific […]

EMCrit Project by Josh Farkas.

]]> 507526 Cervical Artery Dissection https://emcrit.org/ibcc/dissection/ Sat, 14 Feb 2026 22:57:09 +0000 https://emcrit.org/?post_type=ibcc&p=487304 CONTENTS Epidemiology Clinical manifestations Manifestations of internal carotid dissection Manifestations of vertebral dissection Overt trauma complicated by cervical artery dissection Imaging Management Pathophysiology general comments Cervical arterial dissections cause ~2% of all ischemic strokes. (28987426) Dissection is an important cause of stroke in younger patients (e.g., causing roughly 15% of strokes among patients <45 years […]

EMCrit Project by Josh Farkas.

]]> 487304 Elevated intracranial pressure (ICP) https://emcrit.org/ibcc/icp/ Tue, 10 Feb 2026 22:49:52 +0000 https://emcrit.org/?post_type=ibcc&p=489804 CONTENTS treatment of ICP elevation [1] Treat the underlying disease [2] BP management & CPP target [3] pCO2 management [4] Hypertonic therapy [5] Temperature management [6] Sedation & EEG [7] Neurosurgical interventions [8] Polycompartment pressure management diagnosis & monitoring of ICP Noninvasive: Clinical manifestations Neurosonology: ONSD (optic nerve sheath diameter). 📖 Papilledema. 📖 MCA TCD. […]

EMCrit Project by Josh Farkas.

]]> 489804 Acute Ischemic Stroke (AIS) https://emcrit.org/ibcc/ais/ Fri, 30 Jan 2026 16:43:47 +0000 https://emcrit.org/?post_type=ibcc&p=489615 CONTENTS core topics in ICU stroke management [0] Admission labs [1] BP management HTN therapy Hypotension therapy [2] Volume management [3] Anticoagulation & antiplatelet therapy [4] Respiratory support [5] Fever & temperature management [6] Seizure management [7] Nutritional support & dysphagia evaluation [8] Glycemic control specific management situations Neuroworsening in AIS Endovascular therapy & complications […]

EMCrit Project by Josh Farkas.

]]> 489615 Neurological examination & neuroanatomy https://emcrit.org/ibcc/exam/ Wed, 14 Jan 2026 15:59:31 +0000 https://emcrit.org/?post_type=ibcc&p=487070 CONTENTS Rapid Reference 🚀 Neurological examination Global function & mental status Level of consciousness Glasgow Coma Scale (GCS) Motor responses to pain Breathing patterns Aphasia Cranial nerves CN2,3 – Pupillary abnormalities ➡️ CN3,4,6 – Extraocular movements CN3-Oculomotor nerve ➡️ CN6-Abducens nerve Testing of horizontal gaze abnormalities Specific abnormalities of horizontal gaze Peripheral CN6-abducens lesion Lateral […]

EMCrit Project by Josh Farkas.

]]> 487070 Guillain Barre Syndrome (GBS) https://emcrit.org/ibcc/gbs/ Wed, 07 Jan 2026 00:41:12 +0000 https://emcrit.org/?post_type=ibcc&p=489731 CONTENTS Definition and variants AIDP, AMAN, AMSAN Miller-Fisher syndrome spectrum (anti-GQ1b) Other variants Epidemiology Signs & symptoms Diagnosis Differential diagnosis (neuromuscular chapter) ➡️ Lab panel for alternative diagnoses CSF examination Electromyography MRI Ganglioside serology Diagnostic criteria Management [1] Respiratory management Risk assessment & triage Noninvasive respiratory support Decision to intubate Intubation procedure & vent management […]

EMCrit Project by Josh Farkas.

]]> 489731 Cerebral venous thrombosis (CVT) https://emcrit.org/ibcc/cvt/ Tue, 06 Jan 2026 22:42:29 +0000 https://emcrit.org/?post_type=ibcc&p=489725 CONTENTS Epidemiology Signs & symptoms Relationship between thrombus location & clinical features Investigations Laboratory studies Imaging Management General treatment Neurologic deterioration despite treatment Prognosis (Pathophysiology) overall epidemiology Venous thrombosis accounts for ~1% of all strokes. This typically affects young patients (most commonly between 20-50 years old). (29752489) There is a 3-fold female predominance. (Louis 2021) […]

EMCrit Project by Josh Farkas.

]]> 489725 Myasthenia gravis & myasthenic crisis https://emcrit.org/ibcc/myasthenia/ Tue, 06 Jan 2026 00:27:30 +0000 https://emcrit.org/?post_type=ibcc&p=489729 CONTENTS MANAGEMENT OF MYASTHENIC CRISIS [1] Drugs to avoid in myasthenia gravis [2] Respiratory monitoring [3] Respiratory support [4] Nutrition & GI access [5] Pyridostigmine [6] Steroid & immunomodulatory tx [7] PLEX vs. IVIG Myasthenia Gravis: Background information Pathophysiology Presentation Diagnosis Serologic testing & types Myasthenic crisis: diagnosis Diagnosis of myasthenic crisis: basics Differentiation from […]

EMCrit Project by Josh Farkas.

]]> 489729 Spinal Epidural Abscess (SEA) https://emcrit.org/ibcc/sea/ Mon, 05 Jan 2026 16:12:48 +0000 https://emcrit.org/?post_type=ibcc&p=487256 CONTENTS Pathogenesis Epidemiology & risk factors Clinical findings Laboratory studies Imaging studies Antibiotic selection & timing Interventional management route of spread Contiguous spread: Improved imaging techniques have demonstrated that most epidural abscesses result from tracking from a nearby infected musculoskeletal structure (e.g., septic facet joint, discitis, vertebral osteomyelitis). (31021957) Infection may also track from more […]

EMCrit Project by Josh Farkas.

]]> 487256 Posterior Reversible Encephalopathy Syndrome (PRES) https://emcrit.org/ibcc/pres/ Sun, 04 Jan 2026 20:57:54 +0000 https://emcrit.org/?post_type=ibcc&p=489578 CONTENTS Causes Clinical presentation PRES-RCVS overlap syndrome Diagnostic studies Imaging Lumbar puncture EEG & seizure semiology Diagnosis Treatment [1] BP control [2] Sz management [3] Treat cause (review medications) [4] Consider IV magnesium [5] Malignant PRES (Other topics) Pathogenesis Prognosis [1/4] hypertension is the most common contributing factor General principles: The key contributing factor is […]

EMCrit Project by Josh Farkas.

]]> 489578 Viral infections of CNS (mostly: viral encephalitis) https://emcrit.org/ibcc/virus/ Sat, 03 Jan 2026 16:18:06 +0000 https://emcrit.org/?post_type=ibcc&p=489645 CONTENTS Herpesviruses ⍺-herpesviruses HSV encephalitis HSV-2 radiculomyelitis Varicella zoster virus (VZV) β-herpesviruses Cytomegalovirus (CMV) Human herpesvirus 6 (HHV-6) Gamma-herpesviruses Epstein-Barr virus (EBV) Enteroviruses Arboviruses West Nile virus (WNV) Eastern equine encephalitis (EEE) JC virus and PML (progressive multifocal leukoencephalopathy) basics Herpes simplex virus encephalitis is caused mostly by HSV-1 (95% of cases), with 5% of […]

EMCrit Project by Josh Farkas.

]]> 489645 BRASH syndrome https://emcrit.org/ibcc/brash/ https://emcrit.org/ibcc/brash/#respond Fri, 26 Dec 2025 16:20:11 +0000 http://emcrit.org/?post_type=squirt&p=442028 CONTENTS Definition & pathophysiology Epidemiology Chronic risk factors Acute triggers Clinical presentation Diagnosis & differential diagnosis Treatment of BRASH syndrome [1] Epinephrine infusion [2] IV calcium [3] IV insulin & dextrose [4] β-2 agonist [5] Fluid resuscitation [6] Additional tx for bradycardia [7] Diuresis [8] Additional tx for hyperkalemia [9] Evaluate & tx underlying cause […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/brash/feed/ 0 442028 Massive Transfusion/Hemorrhage Protocol (MTP or MHP) https://emcrit.org/ibcc/mtp/ https://emcrit.org/ibcc/mtp/#respond Thu, 25 Dec 2025 14:08:12 +0000 http://emcrit.org/?post_type=squirt&p=438605 CONTENTS Running the MTP [1] MTP labs [2] Access & BP monitoring [3] Consider antifibrinolytic [4] Consider fibrinogen supplementation [5] Consider DDAVP [6] Reversal of other coagulopathies [7] Calcium [8] Avoid acidosis [9] Avoid hypothermia [10] Hemodynamic management [11] Source control Post-MTP assessment & management Background Introduction to massive transfusion protocol (MTP) RIC (rapid infusion […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/mtp/feed/ 0 438605 Immune-related adverse events from checkpoint inhibitors https://emcrit.org/ibcc/checkpoint/ Sat, 20 Dec 2025 13:23:04 +0000 http://emcrit.org/?post_type=ibcc&p=455649 CONTENTS General considerations in patient evaluation Specific organ-system involvement Pneumonitis Epidemiology Presentation Radiology Bronchoscopy Differential diagnosis Evaluation Approach to diagnosis Grading Treatment Myocardial & muscle involvement Myocardial involvement Myositis GI Colitis Hepatitis ATIN (acute tubulointerstitial nephritis) Endocrine Neurologic prime considerations when evaluating a patient  [#1/3] classify the checkpoint inhibitor PD-1 inhibitors: Nivolumab. Pembrolizumab. Cemiplimab. PD-Ligand […]

EMCrit Project by Josh Farkas.

]]> 455649 Coagulation tests (conventional & viscoelastic) https://emcrit.org/ibcc/coag/ https://emcrit.org/ibcc/coag/#respond Fri, 19 Dec 2025 00:10:43 +0000 http://emcrit.org/?post_type=squirt&p=386228 CONTENTS Cell-based coagulation model Traditional tests of enzymatic coagulation INR prolongation with normal PTT PTT prolongation with normal INR Prolongation of both INR & PTT Thrombin Time & fibrinogen “level” (Clauss assay) Thromboelastography (TEG) Strengths and weaknesses of TEG TEG 5000 interpretation TEG 6S interpretation TEG with platelet mapping PFA (Platelet function analyzer) ACT (activated […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/coag/feed/ 0 386228 Invasive candidiasis https://emcrit.org/ibcc/candida/ https://emcrit.org/ibcc/candida/#respond Sun, 14 Dec 2025 20:42:54 +0000 http://emcrit.org/?post_type=squirt&p=443551 CONTENTS Candidemia Epidemiology Clinical manifestations Diagnosis Investigation after diagnosis Treatment for diagnosed candidemia Candidemia involving specific sites: Candida endocarditis CNS candidiasis Ocular candidiasis Intra-abdominal candidiasis Candida pneumonia? Candiduria Other topics Empiric therapy epidemiology of candidemia Invasive candidiasis is often a nosocomial infection that arises in the context of critical illness (especially in patients with long […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/candida/feed/ 0 443551 ECMO manual https://emcrit.org/ibcc/ecmo/ Mon, 08 Dec 2025 13:23:32 +0000 https://emcrit.org/?post_type=ibcc&p=468283 CONTENTS parameters RPM & Flow Pump speed (RPMs) Flow (V̇) Pressures & hemodynamics Hemodynamic monitoring in VV ECMO Hemodynamic monitoring in VA ECMO PVen & drainage insufficiency PInt ▵P & membrane lung dysfunx PArt & return obstruction MAP (VA ECMO only) O2 & oxygenation SvO2 (venous drainage O2%) FdO2 SarO2 & ParO2 (arterial return sat […]

EMCrit Project by Josh Farkas.

]]> 468283 Acute Promyelocytic Leukemia (APL) https://emcrit.org/ibcc/apl/ https://emcrit.org/ibcc/apl/#respond Thu, 04 Dec 2025 14:28:25 +0000 http://emcrit.org/?post_type=squirt&p=394751 CONTENTS Rapid Reference 🚀 Primer Basic physiology of APL Why APL is important in critical care Diagnosis Epidemiology Clinical presentation Diagnostic studies Treatment Early initiation of ATRA Coagulopathy of APL Differentiation syndrome Sepsis Complications from arsenic trioxide Pseudotumor cerebri Acute Promyelocytic Leukemia (APL) management ✅ basic workup & monitoring 📖 Baseline: Echo, EKG, CXR. Electrolytes, […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/apl/feed/ 0 394751 Critical care nutrition https://emcrit.org/ibcc/food/ https://emcrit.org/ibcc/food/#respond Wed, 03 Dec 2025 23:05:25 +0000 http://emcrit.org/?post_type=squirt&p=339397 CONTENTS Creating a tube feeding prescription [#1] Consider refeeding syndrome [#2] Tube feed formulation [#3] Caloric goal [#4] Enter into the tube feeding calculator [#5] Ensure adequate fiber Common troubleshooting issues Avoiding & mitigating interruptions Vomiting & distension Diarrhea Carbohydrate administration & hyperglycemia Other nutrition topics Nutritional physiology in critical illness Nutritional assessment Protein requirement […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/food/feed/ 0 339397 Hypophosphatemia https://emcrit.org/ibcc/hypophos/ https://emcrit.org/ibcc/hypophos/#respond Mon, 01 Dec 2025 12:59:57 +0000 http://emcrit.org/?post_type=squirt&p=440255 CONTENTS Symptoms Phosphate level Causes of hypophosphatemia Investigation of etiology Treatment (Phosphate physiology ➡️) neurologic Paresthesias, tremor. Seizures. Confusion, dysarthria, stupor, coma. (It may promote the development of central pontine myelinolysis.) muscular Rhabdomyolysis: This is rare.  Rhabdomyolysis may mask hypophosphatemia due to the release of phosphate from muscle tissue. Muscle weakness, including the diaphragm.  This […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/hypophos/feed/ 0 440255 Decompensated Hypothyroidism (aka Myxedema Coma) https://emcrit.org/ibcc/myxedema/ https://emcrit.org/ibcc/myxedema/#respond Sat, 29 Nov 2025 21:02:53 +0000 http://emcrit.org/?post_type=squirt&p=386555 CONTENTS Background on decompensated hypothyroidism Definition of decompensated hypothyroidism Epidemiology of decompensated hypothyroidism Recognition of the clinical syndrome Differential diagnosis of decompensated hypothyroidism Lab abnormalities in decompensated hypothyroidism Treatment of decompensated hypothyroidism Treatment of decompensated hypothyroidism Followup Other/related topics Thyroid hormone pharmacology: T4 (levothyroxine) T3 (liothyronine) operational definition of decompensated hypothyroidism “Myxedema Coma” is a […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/myxedema/feed/ 0 386555 Pneumocystis Jiroveci Pneumonia (PJP) https://emcrit.org/ibcc/pjp/ Sat, 29 Nov 2025 12:29:17 +0000 https://emcrit.org/?post_type=ibcc&p=475964 CONTENTS Background: HIV(-)PJP vs. HIV(+)PJP Epidemiology Clinical presentation Radiology Chest radiograph Chest CT scan Blood tests Serum beta-D-glucan ➡️ Other labs (LDH, CRP, PCT) Microbiology tests Bronchoscopy Non-bronchoscopic sampling Approach to diagnosis Early invasive approach Early noninvasive approach Treatment Antibiotics Steroid Prognosis PJP (previously known as Pneumocystis Carinii Pneumonia) presents differently, depending on whether the […]

EMCrit Project by Josh Farkas.

]]> 475964 Hypoglycemia https://emcrit.org/ibcc/hypoglycemia/ https://emcrit.org/ibcc/hypoglycemia/#respond Sat, 29 Nov 2025 03:08:47 +0000 http://emcrit.org/?post_type=squirt&p=409125 CONTENTS Why hypoglycemia is dangerous Symptoms Diagnosis Causes Investigation Treatment Severe hypoglycemia Mild & able to take PO Glucagon is generally not helpful Prevention of hypoglycemia in the ICU patient Persistent hypoglycemic encephalopathy Prolonged severe hypoglycemia can cause permanent brain damage, similar to anoxic brain injury. Hypoglycemia is most dangerous among intubated and sedated patients, […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/hypoglycemia/feed/ 0 409125 Severe influenza https://emcrit.org/ibcc/influenza/ Fri, 28 Nov 2025 14:04:56 +0000 http://emcrit.org/?post_type=ibcc&p=456219 CONTENTS presentation Clinical presentation Radiology Bacterial coinfection core interventions for severe influenza [1] Diagnostic panel [2] Resuscitation [3] Respiratory support [4] Antibacterial therapy [5] Anti-viral therapy other topics Influenza pharmacology Neuraminidase inhibitors (oseltamivir, peramivir) Baloxavir Adjunctive therapy Virus-associated hemophagocytic syndrome (VAHS) Approach to treatment failure Extrapulmonary complications Virology of influenza influenza pneumonia Initial flu-like clinical […]

EMCrit Project by Josh Farkas.

]]> 456219 Thyroid Storm https://emcrit.org/ibcc/tstorm/ https://emcrit.org/ibcc/tstorm/#respond Wed, 26 Nov 2025 00:53:30 +0000 http://emcrit.org/?post_type=squirt&p=438482 CONTENTS diagnosis Approaching the diagnosis Epidemiology & causes of thyrotoxicosis Clinical features Labs Diagnostic criteria for thyroid storm treatment Management of thyroid storm [1] Evaluations to order [2] Steroid [3] Thionamide [4] Iodine [5] Cholestyramine [6] Hyperthermia management [7] Agitation management [8] Cardiovascular management Treatment of specific situations Myth-busting beta-blockers in thyroid storm Atrial fibrillation […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/tstorm/feed/ 0 438482 Preeclampsia & HELLP https://emcrit.org/ibcc/preeclampsia/ https://emcrit.org/ibcc/preeclampsia/#respond Tue, 25 Nov 2025 19:29:33 +0000 http://emcrit.org/?post_type=squirt&p=386617 CONTENTS Diagnosis of preeclampsia Presentation & diagnosis Diagnostic criteria Neurodiagnostic tests Management of (pre)eclampsia [1] Evaluation package [2] BP management [3] Hemodynamic optimization [4] Magnesium [5] Seizure management (eclampsia) [6] Fetal monitoring & delivery [7] DIC [8] AKI [9] DVT prophylaxis Related topics Headache in pregnancy HELLP syndrome treatment when to suspect pre-eclampsia? Preeclampsia has […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/preeclampsia/feed/ 0 386617 Hypercalcemia https://emcrit.org/ibcc/hypercalcemia/ https://emcrit.org/ibcc/hypercalcemia/#respond Thu, 20 Nov 2025 22:45:08 +0000 http://emcrit.org/?post_type=squirt&p=438426 CONTENTS Signs & symptoms Calcium and iCa levels Causes CORE ACTIONS FOR HYPERCALCEMIA [1] Evaluation [2] Treat any underlying etiology [3] Volume resuscitation [4] Calcitonin [5] Bisphosphonate IV zoledronic acid pharmacology Refractory hypercalcemia Milk-alkali syndrome symptoms of hypercalcemia Neurologic: Delirium, which may progress to stupor and coma. Paresthesia. Muscle weakness, hyporeflexia. Gastrointestinal: Abdominal pain (may […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/hypercalcemia/feed/ 0 438426 Clostridioides (prev: clostridium) difficile https://emcrit.org/ibcc/cdiff/ https://emcrit.org/ibcc/cdiff/#respond Thu, 20 Nov 2025 13:03:37 +0000 http://emcrit.org/?post_type=squirt&p=438696 CONTENTS Prevention and C. Diff-o-genic antibiotics Presentation & diagnosis Lab testing Colonoscopy Imaging Risk-stratification Treatment [1] Resuscitation [2] Antibiotic management [3] Promote bowel motility [4] Monitor for megacolon [5] Surgical consultation Followup & de-escalation  (Non-standard therapies) #1. avoid/limit antibiotics Recent guidelines have pared back the use of prophylactic antibiotics for most indications. Emerging evidence suggests […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/cdiff/feed/ 0 438696 Acute-on-chronic liver failure (ACLF) https://emcrit.org/ibcc/aclf/ https://emcrit.org/ibcc/aclf/#respond Thu, 20 Nov 2025 12:07:29 +0000 http://emcrit.org/?post_type=squirt&p=445786 Acute-on-chronic liver failure (ACLF) Definitions Causes of ACLF Comprehensive evaluation in ACLF Management of ACLF Related topics Alcoholic hepatitis ACLF refers to decompensated cirrhosis that is causing organ failure. There are about a dozen different definitions in the literature. The European definitions are listed below, as they seem most useful. In practice, any patient with […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/aclf/feed/ 0 445786 Acute Liver Failure (ALF) https://emcrit.org/ibcc/alf/ https://emcrit.org/ibcc/alf/#respond Thu, 20 Nov 2025 12:07:01 +0000 http://emcrit.org/?post_type=squirt&p=438632 CONTENTS diagnosis & evaluation Definition & classification Diagnosis Causes of acute liver failure Laboratory & imaging evaluation management Liver transplantation N-acetylcysteine & etiology-specific management Acetaminophen poisoning DILI HAV HBV HCV HEV HSV VZV CMV Wilson's disease Autoimmune hepatitis Pregnancy-related Budd-Chiari syndrome Shock liver Malignant infiltration Mushroom poisoning Organ-supportive care: Cardiovascular Pulmonary Gastrointestinal Renal Infectious diseases […]

EMCrit Project by Josh Farkas.

]]> https://emcrit.org/ibcc/alf/feed/ 0 438632