In this 15-minute talk from Rebellion in EM 2021, Dr. Sara Gray, MD uses a case-based discussion to look at ED care from the intensivists perspective and includes quick pearls that make patient care better in the ICU.
Sara Gray, MD
Emergency Medicine/Critical Care
Associate Professor at the University of Toronto
St. Michael’s Hospital
- We will review simple strategies for delivering better clinical care in the ED to critically ill patients
- We will discuss communication strategies: what does your intensivist really want to know?
Delivering Excellent Care to Critically Ill Patients in the ED
- Optimize Resuscitation
- POCUS to assess fluid resuscitation
- Adequate IV access
- NG tube
- HOB elevation
- Early antibiotics in appropriate cases
- Optimize Ventilator Parameters
- Wean FiO2 as tolerated (Avoid hyperoxia)
- TV 4 – 8cc/kg ideal body weight
- Continuous EtCO2 tracing
- Sedation Strategy
- Optimize pain control – Analgesia 1st strategy
- Add sedation 2nd
- Peripheral Pressors Safely
- Big (≥18g) IV in a proximal site to prevent extravasation
- Check site q1hr for color, temperature, and perfusion (Compare to contralateral side)
- What is patients code status? Who did you confirm code status with?
- Easy or difficult airway? Has ramifications for how quickly/safely extubation can occur
Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)
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