This week we discuss more pearls from our morning report conference on APE, SAH and caustic ingestions.



https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_142_0_Final_Cut.m4a



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Tags: APE, Cardiology, Caustic Ingestions, CHF, SAH, SCAPE, Subarachnoid Hemorrhage, Toxicology





Show Notes
Take Home Points

In patients with APE, give high-dose nitro to decrease after load and preload quickly. 400-500 mcg/min for the first 4-5 minutes is my standard approach
Consider DSI to facilitate pre-oxygenation. Ketamine is your go to drug here
A NCHCT performed within 6 hours of symptom onset is extremely sensitive for ruling out SAH but, nothing is 100%. If you’ve got a high-risk patient, you should still consider LP
Patients with caustic ingestions can have rapidly deteriorating airways. Prepare early and be ready to take over the airway at a moments notice

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Core EM: Acute Pulmonary Edema
EMCrit: Sympathetic Crashing Acute Pulmonary Edema (SCAPE)
EMCrit: Delayed Sequence Intubation
Core EM: Setting Up Non-Invasive Ventilation
The SGEM: Thunderstruck (Subarachnoid Hemorrhage)
Friedman BW. Managing Migraine. Ann Emerg Med 2017; 69(2): 202-7. PMID: 27510942


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