You’re working in the ICU overnight and are having difficulty obtaining a blood pressure for a patient that was just transferred to your facility for septic shock secondary to pneumonia. You make the decision to place an arterial line. You place the line sterilely using seldinger technique and connect it to the monitor. Your hard work paid off and you are rewarded with a waveform.
Less than 5 percent of patients hospitalized for acute asthma exacerbation will require mechanical ventilatory support. However, ventilator management in status asthmaticus is unique and the impact of increased airway resistance on ventilation strategies must be understood to avoid life-threatening complications like severe acidosis, barotrauma and hypotension.
The central-line kit has many components, many of which you may never have used. An oft forgotte part of the kit is a catheter-over-needle and this little device might make placing central-lines a whole lot easier.
Watch the video here.
A cardiac arrest arrives to the Emergency Department in January. During the resuscitation it is discovered that the patient is severely hypothermic, and rewarming is begun. A serum potassium results. Which potassium level would prompt you to terminate resuscitative efforts?
Great teams review their performances. A recent publication from George Washington University used video of cardiac arrest resuscitations to generate educational interventions to minimize pulse checks during resuscitation.
- 85 year old male found unresponsive and intubated in the field brought in via EMS
- Per wife, patient was very anxious about election results and took a Valium to relax and sleep
- Wife found him unresponsive next morning
As the number of COVID-19 cases rises drastically and the global pandemic continues to change life as we know it, we are all hoping for news of effective treatment. Approximately 15 percent of patients infected with SARS-CoV-2 develop pneumonia requiring supplemental oxygen and an additional 5 percent progress to critical illness and acute hypoxemic respiratory failure. Although numerous drugs have been investigated, only dexamethasone has demonstrated improved survival in patients hospitalized with COVID-19 in a randomized controlled trial design. We now have data from 3 randomized controlled trials to guide the use of remdesivir for severe COVID-19.