There are some methods to help you manage resuscitation in a crashing patient that may not always come first to your mind.

In his Thursday session, “From Ordinary to Extraordinary: Critical Care Medicine in the ED,” David A. Pearson, MD, FACEP, associate professor and associate residency program director in the department of emergency medicine at Carolinas Medical Center in Charlotte, North Carolina, will share a variety of critical care management options, including ones that may sound out of the ordinary.

“Often, the physiologic effects of intubation in the critically ill patient are overlooked, which leads to chaos during the peri-intubation phase,” he said. “With optimization of the hemodynamics and oxygenation before proceeding with the intubation, many of the untoward effects can be mitigated.”

Dr. Pearson will share information to help maneuver a more controlled environment and safer intubation.

One area that Dr. Pearson will address is standard methods of hemodynamic optimization as well as novel methods such as push-dose pressors using phenylephrine or epinephrine. There are some risks associated with push-dose pressors, Dr. Pearson said. “Specifically, phenylephrine may decrease cerebral tissue oxygenation and should be avoided in brain-injured patients. Additionally, epinephrine is a very common medication associated with administration errors; thus, a full understanding of how to appropriately make an epi push-dose syringe or drip helps to avoid such errors,” he said.

Other areas that Dr. Pearson will cover in his session include what he calls bread-and-butter pre-oxygenation techniques, such as the Rule of 15s, and more advanced pre-oxygenation methods including heated humidified high-flow nasal cannula.

Delayed sequence intubation, refractory hypoxemia, and advanced techniques like extracorporeal membrane oxygenation and high-frequency oscillatory ventilation round out the topics that Dr. Pearson will address in his talk.

Vanessa Caceres is a freelance medical writer based in Florida.

Dr. Pearson

From Ordinary to Extraordinary: Critical Care Medicine in the ED

Thursday, Oct. 29
9–9:50 a.m.
Room 253 ABC