Upstairs Care, Downstairs!


Upstairs Care, DownstairsHappy New Year!

My name is Scott Weingart. I’m an emergency physician intensivist from New York. For the past ten years, I have been hosting a webtext on ED critical care at EMCrit.org. Over the past year, this has flowed into the free EMCrit blog and podcast on all things ED Critical Care.

Both these efforts have been devoted to bringing Upstairs Care, Downstairs. What I mean by this is that geography alone should not determine the aggressiveness of treatment. monitoring, and comfort-giving  in critically ill patients. If the care makes sense and is based on good evidence in the ICU, it should be started the moment the patient rolls through the ED bay doors. Some might consider this far-fetched, but we’ve been trying to make it work for a few years now with some notable successes (and a few set-backs.)

I am pleased to now be able to post my podcasts and show notes here at the Central Line Blog. To start it all off, here are the top 3 posts from 2009:

Sympathetic-surge Crashing Acute Pulmonary Edema – When a patient gets wheeled in with crackles up to their clavicles and a BP of 280/190, the problem is NOT volume overload. These patients need afterload reduction. And if you need to intubate them, it is on some levels a failure [Read More & Listen to the podcast]

Intubating the Critical GI-Bleeder – Nothing is as sphincter-tightening as having to tube a variceal bleed with a belly full of blood. As in so many things, proper planning prevents poor performance.  [Read More & Listen to the podcast]

Non-traumatic Subarachnoid Bleeds – A ton of things need to be done in a very short time in these critically ill SAH patients.
[Read More & Listen to the podcast]

I would love to hear your comments and any suggestions for future topics.

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