Understanding Status Asthmaticus: Treatment and Red Flags
By Dr. Sabrina Berdouk, reviewed by Dr. Abdolghader Pakniyat Introduction A 28-year-old arrives breathless. He has used his salbutamol inhaler more than 20 times in 6 hours. HR 138 | RR 36 | SpO₂ 89% He speaks one word at a time. Then something strange happens. The wheeze disappears. His chest becomes silent. He becomes […]
Critical Minutes in Pediatric Seizure Management
By Dr. Sabrina Berdouk, peer-reviewed by Abdolghader Pakniyat You’re midway through a crowded shift. Monitors beeping, stretchers moving, voices layered over each other in the controlled chaos we call normal. Then the doors open and everything narrows. A parent rushes in, eyes wide with fear, holding a child who is still seizing.And in that instant, […]
From Stable to 70/40: A Push-Dose Pressors Quick Guide
By Sabrina Berdouk, Peer-reviewed by Abdolghader Pakniyat Emergency medicine has a special talent for creating transition points where blood pressure collapses at exactly the wrong moment: after sedation, during RSI, or while you are moving from “temporizing” to “definitive.” In these windows, the problem is not that we do not know what to do. The […]
4 Counter-Intuitive Lessons from an ER That Will Change How You Solve Problems
Peer-reviewed by Dr. Abdolghader Pakniyat Introduction: The Chaos We Think We Know Picture a hospital Emergency Department (ED) late at night. The scene is one of controlled chaos: triage is overwhelmed, a mother is crying in the packed waiting room, and the staff are visibly frustrated. When faced with this kind of systemic stress, our […]
2025 AHA CPR Guidelines: Key Updates and Changes
Peer-reviewed by Dr. Abdolghader Pakniyat Major Structural Changes New Ethics Chapter Unified Chain of Survival Adult Basic Life Support Foreign Body Airway Obstruction (FBAO) – MAJOR CHANGE CPR Techniques Ventilation Updates Pediatric Basic Life Support Infant Chest Compressions – MAJOR CHANGE Pediatric FBAO – MAJOR CHANGE CPR Quality Neonatal Life Support Umbilical Cord Management Airway […]
Does More Shock Improve VF Survival Rates?
1. Start with the Physiology: Why is VF so hard to treat 2. Why DSED? The Physiology Rationale 3. Clinical Evidence: Does DSED Actually Work? A. Randomized Trials B. Meta-analyses & Systematic Reviews C. Observational Data D. Safety 4. So, Why Isn’t DSED “Proven”? 5. Current Clinical Guidelines & Practice 6. Practical “Why” for Management […]
Understanding Shock: Vasopressors
By Dr. Sabrina Berdouk, peer-reviewed by Dr. Abdolghader Pakniyat 1. What Is Shock? Why Does MAP Fall? 2. Categories of Shock: The Core Physiology Type Main Physiology Issue MAP Drop Cause First-line Fix Distributive Pipes too wide (↓SVR) Vasodilation NE (vasoconstrict) Cardiogenic Pump is weak (↓CO) Poor contractility NE ± Dobutamine/Epi Obstructive Pump blocked (↓CO) […]
The Magic of HFNC in the Emergency Department
By Dr. Sabrina Berdouk, Peer reviewed by Dr. Abdolghader Pakniyat Good Morning! I’m excited to present to you the high-impact potential of High Flow Nasal Cannula (HFNC) technology in emergency medicine. Today we’ll explore why HFNC has become a game-changer in respiratory support, particularly in emergency department settings. Meet Our Patient: Magdalena Let me start […]
Work-Life Balance Series: Navigating ER Shifts to Bedtime Routines and Balancing Parenthood with a Career
The Juggling Act: Why Balance Matters and what is it? Opening Story It was National Day, and my children’s nursery had organized a full morning of activities for parents and kids. That day, I was scheduled to cover the pediatric section in the emergency room. So, with a heavy heart and feeling torn, I left […]
“Inferior… But Not Alone: When STEMI Spreads to the Back and Right Heart”
This case presents a 51-year-old male with an acute inferior ST-Elevation Myocardial Infarction (STEMI), diagnosed by ST elevation in leads II, III, and aVF. The key takeaway is that with any inferior STEMI, it is crucial to investigate for both Right Ventricular (RV) and Posterior wall involvement. RV infarction is suspected when ST elevation is […]