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A code stroke is activated, and a CT head shows a left basal ganglia hemorrhage with no vascular lesions on CT angiography. Initial evaluation by medics revealed right arm weakness, a right facial droop, and decreased responsiveness. When he arrives at your ED, the family tells you he was doing fine until dinner.
ultrasound grand rounds: bedside dvt studies - family presence in the ed/icu - r1 clinical knowledge: aicd - r3 small groups: difficult airwaymanagement Ultrasound grand rounds: DVT studies WITH Dr. minges Why should we perform bedside DVT studies in the ED? ETT onto a fiberoptic scope.
Hemodynamic instability and ongoing cardiac arrhythmias are a strong contraindication as chest access for cardiopulmonary resuscitation is limited (Koulouras et. Document thorough skin assessment every nursing shift, and inspect weight-bearing ventral surfaces. Reattach EKG leads to back. Tilt patient into reverse Trendelenburg.
How versatile are your airway skills? Pull out the manikins (or use a volunteer; BVM only) and run some awkward codes! Most airwaymanagement is done with the patient supine and on a table. Importantly, you should practice airway support and BVM facing the patient "from the south" (facing cephalad).
What They Did: Retrospective, observational cohort study in a single high-volume academic hospital The ED had a 5 bed area used for ongoing management and resuscitation of patients who clinically deteriorate while boarding or while actively undergo a workup in other sections of the ED. J Crit Care.
Moreover, when airwaymanagement is needed, advanced airway techniques by ALS crews were associated with decreased odds of survival. Jeff: And if it does happen to be an ALS transport crew, without delaying transport, pain management with fentanyl is both safe and reasonable and preferred over morphine.
This is the fifth part of our series on "Early Modern Resuscitation." " Part I: Oral Airways, early resuscitation, and recognition of airway care. It was not a practical resuscitative aid until production could be commercially successful (~1895) and made portable in compressed form. Pulmotor is 1907.
This Blog episode concerns aspects of the concept of using the nose to obtain an airway or to ventilate emergency patients; it does not deal comprehensively with all aspects thereof that a specialist might do. Few people now remember that a strong early proposal in the move for expired air resuscitation was Mouth to Nose.
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