When the Ultrasound Probe Becomes a Badge
Holding an ultrasound probe is only the beginning. A reflection on peer influence, supervised learning, honest uncertainty, and building a POCUS culture that improves decisions for patients.
Etomidate in the ED and ICU: Hemodynamic Stability Does Not Mean a Stable Intubation
Etomidate may preserve blood pressure better during induction, but it cannot protect a patient from the physiology of intubation. A practical ED and ICU guide to dosing, adrenal suppression, hemodynamic risk, and post-intubation sedation.
Cardiac POCUS: From Basic Views to Bedside Hemodynamics
A step-by-step cardiac POCUS guide for the ED and ICU, from basic views to Doppler and bedside hemodynamics, with practical videos, images, measurement techniques, and clinical pitfalls.
When Should We Stop CPR?
Stopping CPR requires more than a clock, rhythm, or ultrasound image. A practical adult-resuscitation guide to context, physiology, reversible causes, patient goals, and team-based decisions.
Contrast Media in the Emergency Department: A Practical Guide
A practical, evidence-based guide to contrast reactions, kidney risk, premedication, metformin, fasting, extravasation, pregnancy, gadolinium, and urgent imaging decisions in the emergency department.
Understanding Status Asthmaticus: Treatment and Red Flags
By Dr. Sabrina Berdouk, reviewed by Dr. Abdolghader Pakniyat Scope: adult emergency care. The fixed drug doses below are adult regimens. Children require an age- and weight-specific pathway; do not apply this dosing list to them. Introduction A 28-year-old arrives breathless. He has used his salbutamol inhaler more than 20 times in 6 hours. HR […]
Critical Minutes in Pediatric Seizure Management
By Dr. Sabrina Berdouk, peer-reviewed by Abdolghader Pakniyat Scope: Generalized convulsive status epilepticus in infants older than one month and children. Neonatal seizures require a separate neonatal pathway. The ESETT comparison of levetiracetam, fosphenytoin and valproate specified eligibility from age 2 years; its results should not be extrapolated uncritically to younger infants. You’re midway through […]
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: Understanding the Bottleneck Berdouk’s presentation opens with a crowded ED, a distressed mother, frustrated staff, and patients leaving. Dr. Sabrina Berdouk’s ACEM 2025 presentation on quality improvement describes her team’s local experience. 1. Start With a Real Problem, Then Measure It. Start with a problem that patients and staff […]
2025 AHA CPR Guidelines: Key Updates and Changes
Peer-reviewed by Dr. Abdolghader Pakniyat The useful question for a resuscitation team is what to change in practice, what to keep doing, and where the evidence remains uncertain. This selected review of the 2025 AHA CPR guidelines separates adult, pediatric and newborn care. It is not a complete resuscitation algorithm. Major Structural Changes The 2025 […]
Does More Shock Improve VF Survival Rates?
DSED for refractory VF: More delivered energy is not the same as better resuscitation. Double sequential external defibrillation has encouraging trial evidence, but its benefit and implementation remain uncertain. This adult evidence review explains what should change at the bedside and what still requires an approved local protocol. 1. Start with the Physiology: Why is […]
Understanding Shock: Vasopressors
By Dr. Sabrina Berdouk, peer-reviewed by Dr. Abdolghader Pakniyat 1. What Is Shock? Why Does MAP Fall? Shock is inadequate tissue perfusion; normal pressure does not exclude it. MAP − right-atrial pressure ≈ cardiac output × systemic vascular resistance; CO = heart rate × stroke volume. Here SVR is in mmHg·min/L and CO in L/min. […]