Watch the full video here 👉 https://youtu.be/NLuwSAR5OIw

RSI in septic shock: do you risk etomidate-induced adrenal suppression for its hemodynamic stability?

Reuben Strayer, MD (@emupdates) from ResusX:2025: Or is ketamine just the pragmatic default now? What's your call at the bedside? Comment to discuss.

Watch the full video here 👉 https://youtu.be/Ugy8u52BArc?si=CbjTBqp2a12ypqmT

Three pressors in. BP unmoved. Still calling it refractory septic shock — or is it vasoplegia?

Sara Crager, MD (@teachicu) from ResusX:ReUnion:
The distinction changes your whole approach. What does your workup look like before you make that call? Comment 👇

Watch the full video here 👉 https://youtu.be/NLuwSAR5OIw

Seizing patient needs emergent intubation — you reach for etomidate. Is that the right call?

Reuben Strayer, MD (@emupdates) from ResusX:2025:
Etomidate is a pro-convulsant. Does your RSI protocol account for that?
Comment to discuss. 👇

Watch the full video here 👉 https://youtu.be/Ugy8u52BArc?si=CbjTBqp2a12ypqmT

Unknown history, possible G6PD, patient crashing — do you still reach for methylene blue?

Sara Crager, MD (@teachicu) from ResusX:ReUnion:
There's an argument for Cyanokit when the chart is blank. What does your team do in this situation? Comment below. 👇

You just intubated a 5'2" female patient.

Steven T. Haywoood, MD (@heystevemd) from ResusX:2025 🫁:
What's the most common and dangerous mistake you can make when setting the initial tidal volume? Share your approach to lung protection in this patient. Comment to discuss.

Watch the full video here 👉 https://youtu.be/NLuwSAR5OIw

Seizing alcohol withdrawal patient needs the tube.

Reuben Strayer, MD (@emupdates) from ResusX:2025:
You grab propofol — but it wears off in 3 minutes. Is that long enough for someone this benzo-deficient? Midazolam might be the smarter play.

What are you reaching for at your bedside? Comment belo

Your ARDS patient has a PF ratio of 130. You decide to prone — but for how long?

Steven T. Haywoood, MD (@heystevemd) from ResusX:2025 🫁:
Miss the minimum daily duration and you lose the benefit. What does your unit actually do? Comment to discuss 👇

Watch the full video here 👉 https://youtu.be/Ugy8u52BArc?si=CbjTBqp2a12ypqmT

6 liters in. MAP still 58. Do you bolus again?

Sara Crager, MD (@teachicu) from ResusX:ReUnion:
Volume only counts if it's pressurized — and your patient may be past that point. What's your next move at the bedside?
Comment to discuss 👇

Watch the full video here 👉 https://youtu.be/Ugy8u52BArc?si=CbjTBqp2a12ypqmT

Patient's in shock. LV looks hyperdynamic on POCUS.

Sara Crager, MD (@teachicu) from ResusX:ReUnion:
You're about to bolus — but what if the LV only looks dry because of a leaky mitral “pop-off valve”? Have you been caught by this one? Comment to discuss.

Your vented patient’s SpO2 is 99%, FiO2 70%. Do you wean it down — or leave it?

Steven T. Haywoood, MD (@heystevemd) from ResusX:2025 🫁:
Nearly 80% of ventilated patients run hyperoxic. Normoxemia is the target. So what's stopping us? The data on iatrogenic hyperoxia is clear, yet it happens in ~8

Watch the full video here 👉 https://youtu.be/Ugy8u52BArc?si=CbjTBqp2a12ypqmT

Hyperdynamic LV on POCUS?

Sara Crager, MD (@teachicu) from ResusX:ReUnion:
Does it always mean the patient needs volume? Drop your reasoning below 👇

Your patient is obese and newly intubated; the RT is waiting on a tidal volume order.

Steven T. Haywoood, MD (@heystevemd) from ResusX:2025 🫁:
What number are you giving — and how are you getting there? One wrong assumption here can cause real harm. How does your unit handle this at the bedside? C

Vasoplegic shock, MAP in the 50s, HR sitting at 80.

Sara Crager, MD (@teachicu) from ResusX:ReUnion: The team says the HR looks fine. It's not. That blunted compensatory response is actively making things worse. What do you check first when the HR doesn't match the clinical picture? Drop it below.

You're handed a patient on an unfamiliar vent mode.

Steven T. Haywoood, MD (@heystevemd) from ResusX:2025 🫁:
Before you call the RT or look it up, what are the most important parameters you check on the screen to ensure immediate patient safety? Share your bedside protocol in the comments.

i-STAT Alert 🚨
George Willis, MD (@DocWillisMD) from ResusX:2025:
When bedside electrolytes and acid-base status show a total metabolic collapse, the pucker factor is your best diagnostic tool. Pivot from volume-heavy protocols to precision resuscitation immediately. Comment to discuss.

Echo looks great, LV is banging away — but your patient is still on three pressors.

Sara E. Crager, MD (@teachicu) from ResusX:ReUnion:
Do you trust the squeeze? In vasoplegia, that hyperdynamic picture can fool you. What's your next move? Comment to discuss.

What’s the one ventilator mode that still feels like a foreign language to you?

Steven T. Haywoood, MD (@heystevemd) from ResusX:2025 🫁:
Let’s be honest, we all have one. Drop yours in the comments to discuss.

Treating the Metabolic Disaster
George Willis, MD (@DocWillisMD) from ResusX:2025:
Engage your team, establish access, and utilize point-of-care testing. The i-STAT VBG+lytes is perfect for managing severe acidosis and hyperkalemia at the bedside. Comment to discuss.

Three pressors in and the MAP is still tanking — did you check calcium and pH before escalating?

Sara E. Crager, MD (@teachicu) from ResusX:ReUnion:
Hypocalcemia and acidemia blunt every vasopressor you've got. What's your next move at the bedside? Comment to discuss.

Drugs to Avoid in WPW #emergencymedicine #criticalcare YouTube video by EMSwami

WPW: Avoid ABCD drugs (adenosine/amio, beta blockers, CCBs + dig)
- Why? Blocking the AV node pushes all conduction down the accessory pathway + can worsen tachydysrhythmias (like AF w/ WPW)
- Safest drug? Electricity (procainamide also ok but takes too long)

youtube.com/shorts/KE3v4...
#EMIMCC

You inherit a patient on an unfamiliar vent mode at 2am. What's your first move?

Steven T. Haywoood, MD (@heystevemd) from ResusX:2025 🫁:
Spoiler - it's not Googling ASV. It's going back to basics. Has this happened to you? Share how you handled it. 👇

Crashing DKA?
George Willis, MD (@DocWillisMD) from ResusX:2025:
When labs and imaging both look disastrous, the risk of a crash during resuscitation is high. Match the minute ventilation, use balanced fluids, and consider early pressors. Comment to discuss.