Remove Operations Remove Shock Remove Stroke
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The Evolution Of Penetrating Neck Trauma Management – Part 3: Determining Risk

The Trauma Pro

These indicate a high risk for deeper injury and consist of the following: Vascular signs Refractory shock Pulsatile or difficult-to-control hemorrhage Large or expanding hematoma Audible bruit or palpable thrill (I hardly ever see anyone actually check the neck for these, so brush up your skills!) Hard signs.

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Brain Safety After Pulsed Field Ablation for Atrial Fibrillation

Sensible Medicine

PFA destroys myocardium with electricity (shocks). Every “application” is actually a shock. Stroke occurred in 7 patients (0.12%). PFA is especially concerning because the shocks in the left atrium create intense microbubbles. Sensible Medicine is a reader-supported publication.

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Updates in the Management of Refractory Ventricular Tachycardia or Ventricular Fibrillation Arrest

ACEP Now

However, between four and five percent of cases of VT or VF will be refractory to standard management, with nonperfusing arrhythmia persisting despite repeated shocks. Initial guidelines defined “refractory” as VT or VF occurring despite three shocks from a cardiac defibrillator. amiodarone or lidocaine). References Tsao CW, et al.

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ICU Physiology in 1000 Words: The Right Atrial Pressure Does Not Determine Cardiac Output – Part 2

PulmCCM

Kenny MD [ @heart_lung ] In part 1 , right atrial pressure [P ra ] and cardiac output/venous return [CO/VR] were considered as two hemodynamic measures bound at the operating point [OP] of the circulatory system. OP is operating point. Shows what happens when Ppc, Pmsf, Rcardiac and Rvr all vary [grey operating points].

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Journal Feed Weekly Wrap-Up

EMDocs

Spoon Feed In a meta-analysis of patients with septic shock, starting norepinephrine earlier had no mortality benefit, though heterogeneity and bias limit clinically relevant conclusions. Source Comparison of Early and Late Norepinephrine Administration in Patients With Septic Shock: A Systematic Review and Meta-Analysis. 2024.05.042.

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Sniffing out Sepsis - Vibes vs Scoring Systems?

Taming the SRU

National campaigns to improve sepsis care, namely the Centers for Medicare and Medicaid Services’ introduction of “Severe Sepsis and Septic Shock Early Management Bundle”, have faced many challenges in physician and provider adherence. Sepsis as a disease process has been difficult to both clearly define and quickly recognize.

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Grand Rounds Recap 8.16.23

Taming the SRU

to divert the plane). for detecting major injuries Abnormal CXR Rapid deceleration mechanism Presence of a distracting injury Chest wall tenderness Sternal/thoracic spine/scapular tenderness There are limited decision-making rules for thoracic spine imaging Yet a study (Inaba et al., 2015) reported a sensitivity of 98.9%

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