Critical Cases - Torsades de pointes!

A 37 yo female presents with chief complaint of "electric shock" sensations down her arms and intermittent nausea/vomiting over the past week. Her vital signs are unremarkable. Little do you know that this young, well appearing patient has an acute medical emergency which will result in cardiac arrest in a few hours....

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Critical Cases - New Onset Afib with High Output Heart Failure!


  • 49 yo F  pHx asthma presents  ED with worsening DOE for the last month acutely worsening today 
  • No prior hospitalizations or intubations for asthma exacerbation 


  • Positive for dyspnea, palpitation
  • Positive for abdominal distention, which she attributes to constipation


  • Moderate intermittent asthma on albuterol PRN 

Physical Exam

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Critical Procedures: How to Create a Pericardiocentesis Model

Pericardiocentesis is a rarely performed, but potentially life-saving procedure. Commerical models are prohibitively expensive, but students and residents (and critical care fellows) still need to learn the mechanics, ideally with an ultrasound compatibile model. This week's post gives a step by step guide towards making a cheap, easy to fabricate phantom based on this fantastic paper published in the Journal of Emergency Medicne 2012:

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