the 5 minutes huddle*
Administration of sedative followed rapidly by a paralytic. RSI was created as a response to the deleterious effects of aspiration. The technique was to decrease the amount of time that a patient’s airway was unprotected during induction. Pretreatment Agents Fentanyl: 2-10 mcg/kg; Reduces sympathetic responses, useful for patients with head injuries or myocardial ischemia. Lidocaine: Can decrease... Continue Reading →
Hi team! Since we perform NP-POCUS in resuscitating septic patient we might have or might encounter this image/assessment in our apical four chamber view of the heart. The Chiari network, encountered infrequently in the right atrium, is a fenestrated, net-like embryonic remnants of valves of sinus venosus, lying closely in relation to the inferior vena... Continue Reading →
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 →
Code Team Pearls 