Remove Operations Remove Shock Remove Ultrasounds
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Is the blind Subclavian “trauma line” a thing of the past?

Greater Sydney Area HEMS

Obtaining access in shocked trauma patients can be notoriously difficult due to circulatory collapse. Those who are shocked, shut down with limited or no other options for peripheral access require central access. The evidence for improved safety and quality with the use of ultrasound for CVC implementation is well established [i].

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Serial PoCUS for ED Patients with Acute Dyspnea: Is More Actually Better?

RebelEM

Background: Point-of-care ultrasound (PoCUS) is a valuable clinical tool in the assessment of acute dyspnea. Impact of serial cardiopulmonary point-of-care ultrasound exams in patients with acute dyspnoea: a randomized, controlled trial. PoCUS evaluations included lung ultrasound (LUS) and focused cardiac ultrasound (FoCUS).

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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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Ep 164 Cardiogenic Shock Simplified

Emergency Medicine Cases

What is the preferred order of vasopressors and ionotropes in the management of cardiogenic shock? How can we best pick up occult cardiogenic shock before it floured shock kicks in? What is the evidence for intra-aortic balloon pumps, percutaneous ventricular assist devices and ECMO in the patient with cardiogenic shock?

Shock 52
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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. PFA is especially concerning because the shocks in the left atrium create intense microbubbles. What’s more, the lack of esophageal damage has encouraged PFA operators to deliver more (not less) ablation.

Shock 130
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ICU Physiology in 1000 Words: The Right Atrial Pressure Does Not Determine Cardiac Output – Part 1

PulmCCM

Diagnosis because P ra is non-invasively transduced with ultrasound, for instance via the size and collapsibility of the inferior vena cava [1] and/or the Venous Excess Ultrasound Score [VExUS] [2-4]. If changes in P ra cause changes in CO, shouldn’t we then know the etiology of shock with certainty?

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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

The current standard of practice has moved away from landmark-based central line placement given the efficacy and safety of ultrasound-based techniques. Studies have compared IO to peripheral intravenous (PIV) and central venous (CVC) access for resuscitation.