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great talk , question lots of time before we give tPA patient is already on Heparin ( would you start TPA even if they are therapeutic, wondering what protocol do you follow) ,, 2. if someone is on Eliquis and has eliquis failure will you consider TPA if they are sick submassive or massive 3. After TPA when do you start AC (Heparin gtt)
Good questions imo. Nr. 2 (maybe even the nr. 1) is answered in the moderate bleeding risk box, as anticoagulation is one of those criteria
Do you check a random cortisol level to decide stress dose steroids in septic shock?
Why would you use Solumedrol q6hrs in status asthmatic? If half life is >6hrs like u mentioned before ?
Most awesome...thank you Sara!
@criticalcarenow. I like it...but can you do this in the prehospital setting? If so, how? It could be game changing
I just started taking magnesium and remain hopeful!
If you are in 60l/97% pstient still labor breathing but spo2 98 percent for 4 hours and abg po2 60[ normal 60 -100). Oh is normal 7.35[ normal 7.35-7.45). Do patient is agitated with altered mental status. Do i need to keep same settih because spo2 is normal?
Sorry, I came to learn and got completely overwhelmed with two docs talking over the presentation.
Awesome. So happy you enjoyed it
Is there any negative effects on serum blood sugar in giving isotonic bicarb solution during the early phase of DKA management considering the solution is made with D5W? Can a litre of sterile water be an appropriate substitute to D5W? Thanks.
Brilliant!
Works for me. No more afib!
The PART trial (Similar to the ROC PRIMED trial, also found survival to be higher in patient's with only BVM ventilation. It's also worth mentioning regarding the AIRWAYS-2 trial that in the UK ground crews do not intubate in cardiac arrest. They rarely intubate at all. That is almost entirely within the purview of HEMS.
1:18 - - (44 y/o OD’d on heroine in ER, PA arrest, prolonged resuscitation, severe anoxic brain injury) 1:10 - - 9 days s/p trach, *tachycardic,* “sick kipnuk”(?), severe respiratory distress, hypertensive 1:35 - - 110,000 tracheostomies performed annually in the US 1:43 - - 40-50% of trached patients will have a complication (most in ICU), most minor req minimal intervention 1:54 - - (1% of trached patients suffer a catastrophic airway complication) 1:59 - - *HALF of airway deaths in ER or ICU are due to DISLODGMENT or DECANNULATION*
Thx prof....legendary
One of the side effect that limits its use in higher doses is "Tachyarrhythmias"..in that case what would you suggest to continue Norepi at higher dose or just taperdown and add another agent as adjuvant.?
Great lecture. A classic
manual palpation on the femoral can simply be hard to find in the moment, let alone on someone that may have very low pressure. a dirty but useful trick i like using is a O2 probe wrapped around the earlobe. while they are innaccurate for Saturation, they can be useful at detecting a pulse in cardiac arrest situations. love me some doppler though
This was really helpful, and I am looking forward to the next episode.
The Vfib that looks like asystole? Tell me about it.
A great presentation! I especially liked the talking points about managing AD complications. It’s a frightening diagnosis that’s out there to get you! I’ve had a patient with a unilateral lower limb weakness and weak distal pulses who ended up having an AD! He did have HTN and was a smoker.
Once the patient has been stabilized would you check an ammonia level considering his mental status and history of alcohol?
Great discussion
Very interesting. Thanks for sharing.
👍👍👍👍
What’s the dose?
Am sure your video save life even you don't know when, where and who they are. Thanks.
Thnk you soooooooo MUCH 🙏🏼
Alternative names: Critical care coffee Intensive coffee unit
Loved it. Excited for the next episodes.
Thanks for the awesome case discussion! A quick question: Initially when the patient's BP and HR started crashing, was there a conscious decision not to use atropine? or was push-dose epi just a preference of yours?
To my understanding atropine isn’t indicated in someone who is also hypotensive
This coffee thing is great can’t wait for more episodes
Dr Coletta seems like a very well trained doctor…where did he learn his craft????
Preliminary results appear promising.
Great presentation. Thanks.
Why do they keep pushing TXA, I am sure it has it's place in medicine but study after study trying to make it beneficial and prove it DOES work 🤷♂️
But it does work, right?
@@CriticalCareNow Depends on what kaleidoscope you're looking through 👀 at the moment.
Are their and age related cautions?
🎉great presentation
Sara Crager has helped me not only survive but thrive in fellowship. I probably listened to her RV failure lectures at least 10x. ICUedu, crit care now in addition to all the standard FOAMeds for CC (emcrit, IBCC, pulmpeeps) have been a godsend for trainees like me.
Sir, How long can we allow peak airway pressure of near 60 ? Or decrease the limit as early as possible?
Giving peep counters beathing out? Isn't that the biggest paradox of the century? I've been always taught to peep to cancel out autopeep
I take he's talking about Chris Hicks for the video that has the path of the trauma resident, right? where can i find it?
I would love to work with Dr. Weingart! My way of wanting things to function in an E.D. almost match his perfectly
Could you please link the sources you use in the presentation?
Thank you Haney, your effort to provide great education is appreciated, excellent lectures!
Thanks and you’re welcome
Legend 🫡
Hey Laura , thank you for covering the topic so clearly, simply and elaborately. i am going to do it tomorrow on a 70 yrs old male patient with a big mass near the glottic opening. Thank you.
Wonderful informative lecture ❤
To add what I have done in my practice if oxygenation is an issue based on cxr and spo2, I continue going up on peep as long as driving pressure ok and definitely the “chair” position to recruit FRC. I have gone as high as peep of 20+ as long as dp is acceptable. Don’t forget to adjust peak airway threshold/limit
Thanks for this. Very insight stuff!
FFP replenish the ACE enzyme in the receiving patient.