Getting to ECLS – Optimizing Organ Perfusion via CPR prior to ECPR Activation

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…

Resus C4: Septic shock, Pressor Angst, and Vaso vs. Epi

Clinical questions addressed in this C4

  • What should be the first-line vasopressor in septic shock?
  • What is the correct timing to initiate vasopressor therapy?
  • What’s your contingency pressor if your NE doses are escalating?
  • What are some of your resuscitation end-points in the patient with septic shock?
  • 2015 Penn HART Course

    Do you manage patients who’ve had a cardiac arrest? Has the debate over 33 vs. 36 C made you uneasy?  Do you know what to monitor after you’ve reached your targeted temperature management (TTM) goal?  Are you still calling TTM, “therapeutic hypothermia”?

    Well come join us on October 29-30th at the Loews Hotel in Philadelphia, PA and find out why this is a “Can’t Miss” conference of 2015!

    Resus C4 Series

    We are excited about a new educational series that has developed out of the University of Pennsylvania’s Department of Emergency Medicine Resuscitation Rotation.  The goal will be to: Ask 4

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