the 5 minutes huddle*
Paroxysmal Sympathetic Hyperactivity after acquired brain injury; overstimulation secondary to TBI Treatment strategies target the inhibition of central sympathetic output, afferent sensory input, and effector organ responses to sympathetic stimulation. adrenergic agonists | Dexmedetomidine, clonidine; used to control central and peripheral adrenergic activities non selective b-blockers | Propranolol is a lipophilic, central inhibition of catecholamine... Continue Reading →
The RUHS code team has collaborated with flosonic with its revolutionary wearable ultrasound patch in gathering pertinent information to assist and aid in fluid management and sepsis resuscitation. Together with our nurse performed POCUS and the flopatch, these tools are life saving and performance changing for the whole critical care team. RUHS code team assesses... Continue Reading →
Hey guys. Have you had your coffee? How's the migraine? We have had a day with a back to back inderal overdose case in the emergency department. This is a quick 5 minute overview of Inderal treatment and management. Overview: most commonly prescribed drugs for the treatment of various cardiac disorders, hyperthyroidism, migraine, glaucoma, and... Continue Reading →
Discovered in 1956, also called human respiratory syncytial virus (hRSV) and human orthopneumovirus. Orthopneumovirus consists of pathogens that target the upper respiratory tract; found among sheep, cows, and most importantly humans. leading cause of bronchiolitis and pneumonia in infants and children worldwide under the age of 5. Transmission through droplets and aerosols, live for up... Continue Reading →
Catecholamine Dopamine exerts its effects on both dopaminergic and adrenergic receptors. The meta-analysis from the Surviving Sepsis Campaign guidelines 2015 did not endorse the use of dopamine due to its association with increased mortality and arrhythmias when compared to norepinephrine. However, it may be considered as an alternative to norepinephrine in patients deemed to have... Continue Reading →
Background: At 19:25 just after the ED huddle my partner and I get a consult call from the emergency department regarding a 56 YO female who came in for SOB 15L 02 via NRM by ambulance. She has audible expiratory wheezing and has coarse crackles upon auscultation. She is a frequent to the emergency department... Continue Reading →
Hadoff at 06:00, Septic activation; SIRS X 3, lactate 4.. Fluid resuscitated at hour three, completed 3L LR bolus. Hemodynamics; SV 89, CO 7L/min, SVR 856 after second vasopressor support. Patient is intubated and sedated. Background: Patient was a trauma activation 7 days prior with multiple surgical intervention including spleenectomy persisted to be hypotensive despite... Continue Reading →
Case study: You are responding to a code blue. Patient went bradycardic in the 30's; unresponsive. Atropine 1 mg was given but did not improve heart rate. Previous EKG showed sinus bradycardia with discernable P waves. You are manning the monitor; 1 epi given and after just one round of CPR there is ROSC. You... Continue Reading →
Case study: 59 male came in with wound abscess; Pt map is 60 mmHg with 2 positive SIRS criteria; HR 100, Tmax 100.9F. Pt was placed on a non invasive hemodynamic monitoring. CO has been getting worse but SBP is maintaining at 110 mmHg. What's going on with this patient? Flow decrease before pressure decrease... Continue Reading →
Case report: Hey guys, we had a patient that came in for acute AMS with neural focal deficit- activated as a code stroke. Patient was found to have acute infarct, acute subarachnoid hemorrhages on the CT non contrast. Patient was also positive for SIRS with significant infectious process, increased WBC and lactate. History of recent... Continue Reading →
Code Team Pearls 