The crucial hours of an illness often take place when a patient is in the emergency department. It’s during this time that lives can be saved—or lost. This is especially true as the amount of critical care delivered to emergency department patients continues to rise, said Michael E. Winters, MD, FACEP, associate professor of emergency medicine, University of Maryland School of Medicine, Baltimore.

Michael E. Winters, MD, FACEP

To help emergency physicians manage the large amount of literature-based information available about critical care, Winter’s session “Cruising the Literature: Top Articles in Critical Care” will address select articles from the previous year that pertain to the care of critical topics commonly encountered in the emergency department.

Some common topics include intracerebral hemorrhage, fluid resuscitation, sepsis, and cardiac arrest. The presentation also will cover recent literature reports related to sepsis and cardiac arrest care.

One area addressed in the literature recently and that will be covered during the presentation is intracerebral hemorrhage, Dr. Winters said. Two key articles—ATACH-2 and PATCH—have provided further information on blood pressure management and the transfusion of platelets for patients taking an antiplatelet medication. The recently published literature shows that in terms of fluid resuscitation, almost 50 percent of critically ill patients don’t increase their cardiac output with additional fluid administration. “In these patients, additional fluids result in organ congestion and organ dysfunction,” Dr. Winters said. “Therefore, it’s imperative to be able to determine which patients need more fluid therapy.”

Dr. Winters’ talk also will address the utility of the passive leg raise test to assess fluid responsiveness, including how to perform the test, the pitfalls in interpretation, and the latest meta-analysis on passive leg raise recently published in Critical Care Medicine.

Vanessa Caceres is a freelance medical writer based in Florida.