This past month was our Annual University of Pennsylvania Adult ECMO symposium. One of the talks addressed optimizing a patient prior to ECPR activation. In this demo, we walked the patient through how we optimize our patients organ perfusion while identifying, “ACLS Refractory” cardiac arrest care and those who meet inclusion for E-CPR.
Resuscitation Choreography – Roles, logistics, and prebriefing
The need for effective team leadership is probably one of the most important aspects of running a successful medical, trauma, & cardiac arrest resuscitation. The primary literature is littered with research aimed at describing effective leadership strategies during high-quality resuscitation teams. But at the end of the day, the key word here is… team.
Resus C4: Resus goals for the Sickler with MODS
Clinical questions addressed in this C4:
1. What is Acute Multiorgan Dysfunction Syndrome (MODS) in sickle cell patients?
2. Why do patients with SSD develop acute MODS?
3. What type of venous access will you need for exchange transfusion?
4. What are some of your resuscitation end-points in the patient with SSD associated MODS?
Resus C4: Induction Phase Logistics of Targeted Temperature Management
Clinical questions addressed in this C4:
1. Who should be cooled after ROSC and when?
2. How are you going to reach your target temperature?
3. How should you approach shivering during the induction phase of TTM?
4. How should you approach oxygenation and ventilation using an ABG in the patient receiving TTM?
Resus C4: What is the role of steroids in severe sepsis & septic shock?
Clinical questions addressed in this C4:
1. Why do we give steroids in septic shock?
2. When is the appropriate time to initiate hydrocortisone therapy?
3. Are there any adverse effects of hydrocortisone therapy?
4. Are there any other immunomodulatory agents we should be giving to patients with septic shock?
Personalized Resuscitation Metrics – Sepsis, Early Antibiotics, and the Dilemma of Speed vs. Accuracy
One of the most important concepts that is often left out of the commonly quoted “early antibiotics” mantra is appropriate antibiotic therapy. While it is often difficult to determine what is appropriate for each patient presenting with severe sepsis, there are a number of tools that must be considered what choosing your gorillacillin variant. We should be striving to identify personalized metrics for resuscitation…
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