Resus Now

Please review below articles pertaining to todays show!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC558461/


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299161/

IT'S THE HALLOWEEN SPECIAL, PART TWO! Ralph & Dr. Barker are joined by Dr. Daniel Liesen, who is here to discuss thoracotomies in the emergency department.     

Remember:
1. Know your indications and contraindications and ensure back up is available and on their  way.
2. Prepare your equipment
3. Incise and gain entry also intubate right mainstem and know how to use your spreaders!
4. LOOK!!!   
5. Control hemorrhage that is visible and open pericardium-control direct cardiac bleeding
6. Clamp the aorta above the diaphragm- Time is ticking.....
7. Open cardiac massage/defibrillation
8. Avoid further air embolism if any present
9. Got ROSC and adequate vital signs————-> To the OR
10. Always be careful please!

Below are some great instructional links and evidence based articles. 
             
https://emj.bmj.com/content/22/1/22

https://www.facs.org/-/media/files/quality-programs/trauma/publications/thoracotomy.ashx

https://litfl.com/resuscitative-thoracotomy/

https://www.east.org/education/practice-management-guidelines/emergency-department-thoracotomy

https://rebelem.com/if-youre-going-to-do-the-thoracotomydo-a-clamshell/

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiHnNHUzdvsAhWriK0KHcJ_B-UQwqsBMAF6BAgFEAM&url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3D924t8kpW-p4&usg=AOvVaw170N7m070KxjSCUWwAJRKY

https://www.uptodate.com/contents/resuscitative-thoracotomy-technique

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802990/

IT'S THE (EARLY) HALLOWEEN SPECIAL, PART ONE! Ralph & Dr. Barker are joined by Dr. Daniel Liesen, who is here to discuss thoracotomies in the emergency department.

Remember:
1. Know your indications and contraindications and ensure back up is available and on their  way.
2. Prepare your equipment
3. Incise and gain entry also intubate right mainstem and know how to use your spreaders!
4. LOOK!!!   
5. Control hemorrhage that is visible and open pericardium-control direct cardiac bleeding
6. Clamp the aorta above the diaphragm- Time is ticking.....
7. Open cardiac massage/defibrillation
8. Avoid further air embolism if any present
9. Got ROSC and adequate vital signs————-> To the OR
10. Always be careful please!

Below are some great instructional links and evidence based articles. 
             
https://emj.bmj.com/content/22/1/22

https://www.facs.org/-/media/files/quality-programs/trauma/publications/thoracotomy.ashx

https://litfl.com/resuscitative-thoracotomy/

https://www.east.org/education/practice-management-guidelines/emergency-department-thoracotomy

https://rebelem.com/if-youre-going-to-do-the-thoracotomydo-a-clamshell/

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiHnNHUzdvsAhWriK0KHcJ_B-UQwqsBMAF6BAgFEAM&url=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3D924t8kpW-p4&usg=AOvVaw170N7m070KxjSCUWwAJRKY

https://www.uptodate.com/contents/resuscitative-thoracotomy-technique

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802990/

In this 5 minute bit, we talk about treatment and chest tube size options for the simple pneumothorax.  Please see below for evidence related articles:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5334075/

http://jtd.amegroups.com/article/view/8006/html       

https://www.cookmedical.com/critical-care/in-favor-of-small-bore-the-efficacy-of-pigtail-catheters-for-pleural-and-pericardial-drainage/                    

In this 5 minute bit, we discuss the emergency treatment of the tension pneumothorax using the finger thoracostomy. Please see attached evidence based articles associated with the episode. 


https://pubmed.ncbi.nlm.nih.gov/22987168/

In this episode Ralph goes over the use of the arterial line in cardiac arrest.  Please see below evidence related articles to supplement this 5 minute bit.

https://pubmed.ncbi.nlm.nih.gov/4064112/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4087068/pdf/nihms-598128.pdf

https://emcrit.org/wp-content/uploads/2018/07/DBP-vs-ETCO2.pdf

Below is an excellent blog post and podcast done by Scott Weingart of EMCrit. This clears up where your diastolic value is during mechanical CPR. 
https://emcrit.org/emcrit/dbp-cpr/

https://emottawablog.com/2020/04/nurse-led-acls/

Ralph is joined by Dr. Kelly Wren in a discussion about an anhydrous ammonia spill and the aftermath in the Emergency Department.

https://journals.lww.com/em-news/Fulltext/2020/08000/News__Toxic_Gas_Leak_Holds_Lessons_for_COVID_19.8.aspx