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Resuscitation

1.1  Adopts a structured and timely approach to the recognition, assessment and stabilisation of the acutely ill patient with disordered physiology 

1.2  Manages cardiopulmonary resuscitation 

1.3  Manages the patient post-resuscitation 

1.4  Triages and prioritises patients appropriately, including timely admission to ICU

1.5  Assesses and provides initial management of the trauma patient

1.6  Assesses and provides initial management of the patient with burns

1.7  Describes the management of mass casualties

Assessment of the acutely ill patient

EMCrit podcast update on Apnoeic Oxygenation

January 01, 2020

EMCrit Podcast 206 – ApOx, ENDAO, & PreOx Update

Fluid Responsiveness from the Ultrasound podcast

January 01, 2020

Fluid Responsiveness: The Ultrasound podcast 

Traumatic Cardiac Arrest from the ResusRoom Podcast

January 01, 2020

Great summary about the controversies and strategies for the management of traumatic cardiac arrest (non-penetrating)

Key points

  • HEMS data from 2006 survival to discharge 7.5% (not all good neurological recovery)

  • Meta-analysis those undergoing resuscitative thoracotomy had survival of 1.5% to discharge

  • Remember mnemonic HOT for reversible causes of traumatic cardiac arrest: Hypovolaemia, Oxygenation, tension/tamponade

  • Chest compressions de-emphasised in guidelines

 

Key Management

  • Team approach to complex case

  • Stop bleeding (Splint/pelvic binder/TXA)

  • Manage Airway (LMA may be adequate), minimise IPPV

  • IO/IV and blood products

  • Consider bilateral chest decompression for tamponade

  • Consider tamponade as an uncommon cause in blunt trauma (echo may help)

  • Consider resuscitative thoracotomy and proximal aortic compression if signs of life within last 10 mins and traumatic cardiac arrest.

  • Chest compressions may impede management and may not work if tension/tamponade/absolute hypovolaemia.

Why we are doing CPR wrong: Podcast and Vodcast about TOE in cardiac arrest from EMCrit

January 01, 2020

Is Transoesophageal Echo (TOE)coming to an ITU near you? A new paradigm during in-hospital CPR?

Key Points

This is an interesting post about how TOE can be used to ensure correct placement of the hands or mechanical CPR device over the Left Ventricle (LV) during CPR. This small series show how placement of the hands over the Left Ventricular Outflow Tract (LVOT)impedes blood flow in contrast to the placement over the LV.

Makes physiological sense but is this a realistic option to set up in your unit. A good discussion point around cardiac arrest. 

Check out the Vodcast and go to Emcrit via the link below for the show notes and the podcast

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