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Sodium bicarbonate use during pediatric cardiopulmonary resuscitation: a secondary analysis of the icu-resuscitation project trial. Pediatric Crit Care Med. 2022 Date: February 15, 2023 Guest Skeptic: Dr. Carlie Myers is Pediatric CriticalCare Attending at Cincinnati Children’s Hospital Medical Center.
Author: Brit Long, MD (@long_brit) // Reviewed by Alex Koyfman, MD (@EMHighAK) The American Heart Association (AHA) and Neurocritical Care Society (NCS) released their 2023 Scientific Statement on the criticalcare management of post ROSC patients. Statements: Initiate EN as soon as possible after ICU admission (100%, 20/20).
Stephanie Martin (Twitter: @OBCriticalCare, Instagram: @criticalcareob), medical director for Clinical Concepts in Obstetrics and a Maternal Fetal Medicine specialist in Scottsdale, Arizona with expertise in criticalcare obstetrics. She is also co-host of the CriticalCare Obstetrics podcast. This is not the goal.*
Introduction Cardiopulmonary resuscitation (CPR) is a life-saving procedure performed on individuals experiencing cardiac arrest. One of the treatments historically used during CPR is sodium bicarbonate, intended to counteract the negative effects of metabolic acidosis.
In response to this critical issue, the TAME Cardiac Arrest Trial has been launched as a definitive phase III multi-center randomized controlled trial for resuscitated cardiac arrest patients. Monitoring cerebral pressures is crucial in assessing the impact of interventions, especially in criticalcare scenarios.
His daughter immediately started CPR and another family member called EMS. Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing criticalcare. When EMS arrived the patient was in ventricular fibrillation. Two subsequent troponins were down trending.
The Importance of Civility in CriticalCare Resuscitation A 3-year-old patient with diabetic ketoacidosis arrives at your ED. The team sits down for a hot debrief once the patient is stabilised and transferred to the ICU. Conclusion Criticalcare resuscitation is stressful. Incivility can mean many things.
Louis) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case You are working in the trauma/criticalcare pod of your emergency department (ED). He requires low-dose epinephrine to maintain his mean arterial pressure (MAP) in the 60s mmHg and is transported to the cardiothoracic (CT) ICU.
Interventions during the acute phase of treatment post return of spontaneous circulation (ROSC) are therefore critical. 1 The primary goal of cardiopulmonary resuscitation (CPR) is to optimize coronary perfusion pressure and maintain systemic perfusion in order to prevent neurologic and other end-organ damage while working to achieve ROSC.
Recent studies on patients requiring criticalcare have demonstrated that hyperoxia is harmful and instead we should be targeting normoxia (SpO2>93%). Background: Hypoxemia and hypoperfusion are important factors in outcomes after ROSC. Liberal O2 (PaO2 13 to 14kPa (98 to 105mmHg) Initial FiO2 set at 0.6 Liberal O2: 33.9%
7 TTM2 is generally interpreted as favoring normothermia for post-arrest care, but the question is whether this trial is broadly applicable to many countries with less developed community CPR involvement. Crit Care Med. degrees Celsius “is a reasonable and evidence-based approach.” Circulation. 2015;132(25):2448-56.
Bend the stylet Unless youre a lunatic who likes surprises during criticalcare procedures, you should bend your own stylet. It is true, someone finally did an RTC on ICU level patients and found that first pass success IS better with VL than DL (Prekker 2023), but the fact remains that sometimes VL fails. 2004): 518-520.
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