An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
Your patient suffered a cardiac arrest and we have achieved ROSC.They are hypotensive and need vasopressors.What MAP should we target in patients after cardiac arrest?The surviving sepsis campaign likes for us to shoot for 65 in septic shock patients.Other studies have shown that patients who are chronically hypertensive could do better with 75.Current guidelines also …
Continue reading MAP (Mean Arterial Pressure) Goal/Target After Cardiac Arrest
Should we be using amiodarone or lidocaine for patients who go into cardiac arrest due to ventricular tachycardia or ventricular fibrillation while in the hospital? The ACLS guidelines support the use of either. I have personally noted far more use of amiodarone over lidocaine for this issue. These data published in the May 2023 issue …
Continue reading Amiodarone or Lidocaine for In-Hospital Cardiac Arrest?
After a patient suffers a cardiac arrest event, should we be giving them corticosteroids?This is not something I do currently in my practice so I am intrigued by these data.There's a ton of nuance to this brand new systematic review and meta-analysis so please read it for yourself.This is not medical advice. Hat tip to …
Continue reading Corticosteroids and Cardiac Arrest: One-Minute Journal Club
CODE BLUE! Run! Run! Arrive and the patient has no IV access. What should we do next? Place a peripheral IV or place an intraosseous access? Which will lead to better outcomes? These authors took a retrospective look at in-hospital cardiac arrest at one center. They looked at a total of 1039 patients when it …
Continue reading In-Hospital Cardiac Arrest! No Access. Place an IV or an IO?
Let's start off with the basics. ECMO is the medical abbreviation for Extra Corporeal Membrane Oxygenation. This means that the system takes blood out of your body run its through a circuit, and puts oxygen into it. It can obviously do other things which I will cover below. There are two types of ECMO, VA …
We’re getting better with our management of out of hospital cardiac arrest via quality bystander CPR. The majority of this credit should go to the organizations such as the AHA who puts together programs taught by firefighters, paramedics and EMT’s (forgive me if I screw up the semantics) to health care personnel and the lay …
Yesterday, @yournursingeducator created a great post on Code Blue tips. @fobiesme asked a very legitimate question regarding how to proceed in patients who are s/p bypass or any open chest situation in the CVICU. This was something I wondered about myself even as someone who taught ACLS for the AHA at a point in my …
Continue reading Cardiopulmonary Resuscitation: ACLS in the CVICU
