A Cook County Hospital Emergency Medicine Blog for up-to-date medicine and more.
We start this lovely Wednesday with EMS bringing in a 70-year-old man who just had a v-fib/v-tach arrest. After 5 rounds of CPR, 4 shocks, and 3 doses of epi, they’ve got him back! You prep airway equipment and the ultrasound, and in a few minutes, the patient arrives.
Samson Frendo MD and Eric Leser MD
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Figure 1. BRASH Syndrome feedback loop (Source: https://litfl.com/brash-syndrome/)
It’s 3 a.m. on an overnight shift and the resuscitation room nurse runs over, “Hey doc, the patient in R3 is bradycardic and now his blood pressure is dropping”. You rush in, begin thinking through which medications to give and place pads on the patient. Luckily, he begins to stabilize with vasopressors and pacing. You review his labs again; he has worsening renal function and he’s mildly hyperkalemic to 5.7. He has metoprolol on his medication list but denies taking more than prescribed. So what’s actually going on?
Today we will discuss BRASH syndrome, which stands for Bradycardia, Renal failure, AV Blockade, Shock and Hyperkalemia.
Kathryn McGregor, MD and Eric Leser, MD
Read MoreManaging the physiologically difficult airway is one of the highest acuity and highest stress challenges in the Emergency Department (ED) setting. Here, we will discuss pre-oxygenation with non-invasive ventilation.
Kathryn McGregor, MD; Taylor Wahrenbrock, MD; Eric Leser, MD
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