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This is part 1/3 in our subclavian central line series. First we discuss the blind approach and see this excellent video on the procedure. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiWi9bi16HuAhXBQc0KHfqwCY4QFjAMegQIAxAC&url=https%3A%2F%2Fjomi.com%2Farticle%2F290.14%2FBlind-Technique-for-Subclavian-Central-Line-Placem…
 
The retrograde intubation! An oldy but goody and a nice trick to keep in your back pocket. 1. Prep the neck 2. Identify the anatomy and your Cricothyroid membrane 3. Introduce your needle with syringe attached through cricothyroid membrane in a cranial (cephalad) direction. Withdraw plunger and confirm position with whisp of air in syringe (can hav…
 
Part 4 of 4! Things we talk about: 1. Reinforce safety, never have your finger in the same hole as a scalpel. 2. Extend your incision from sternal notch to hyoid bone (in the midline) if anatomy is not palpable. 3. Be wary of previous front of the neck surgical scars! 4. The wired jaw airway emergency. See below 5. Nasotracheal intubation and fiber…
 
This is part 3 of 4 in the surgical airway series. We discuss pitfalls including entering a false passage with the bougie. Watch the below video from EMCrit, George Kovacs, as I referenced in the podcast demonstrates that “hold up” is possible in a false passage. All credit goes to Dr. Weingart, Dr. Kovacs and all the brilliant airway gurus for con…
 
This is part 2 of 4 in a our surgical airway series. Below are some good videos on the proper approach and technique. Credit goes to Scott Weingart, my RLA professor and the host of EMCrit podcast as this technique was adopted from his teaching. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjm0fHdxqHuAhXVK80KHWG2AosQwqsB…
 
This is part 1 of 4 in a our surgical airway series. Below are some good videos on the proper approach and technique. Credit goes to Scott Weingart, my RLA professor and the host of EMCrit podcast as this technique was adopted from his teaching. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjm0fHdxqHuAhXVK80KHWG2AosQwqsB…
 
On this episode, We discuss some contraindications, controversies, data analysis of different clinical trials of TXA, and much more! Please see links below for referenced articles in the show. http://www.emra.org/emresident/article/critcare-alert-crash3/ https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-020-04623-5 https://emcrit.org/…
 
In this 5 minute bit, we discuss scenario based pressor selection, vasopressors to choose in the face of RV failure or pulmonary hypertension, and peripheral vasopressors. Below you will find evidence related articles on vasopressin and dobutamine effect on pulmonary vascular resistance, safety profile of peripheral pressors and an interesting arti…
 
In this 5 minute bit we discuss Phenylephrine, Angiotensin II, Dobutamine and Milrinone. Please see attached evidence related to our topic: *Just to clarify, dobutamine and milrinone can both be used for right ventricular systolic failure but there is some evidence that milrinone may provide better pulmonary vascular afterload reduction than dobuta…
 
In this episode, 2 Intensivists Dr. Srinivasan and Dr. Patel visit Resus Now to discuss todays approach on taking care of patients with COVID 19 illness. Please see below articles for evidence related to todays topic. Dexamethasone article: https://www.nejm.org/doi/full/10.1056/NEJMoa2021436 Tocilizumab article: https://www.nejm.org/doi/full/10.105…
 
In this 5 minute bit, we discuss pearls and pitfalls with Norepinephrine, epinephrine, dopamine and vasopressin. Please see below for evidence related to our topic. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495871/ https://pubmed.ncbi.nlm.nih.gov/18654759/ https://emcrit.org/pulmcrit/renal-microvascular-hemodynamics-in-sepsis-a-new-paradigm/ ht…
 
Review the below articles thoroughly before placing a temporary dialysis catheter. Remember RIJ is site of choice followed by femoral. LIJ not ideal and avoid subclavian. Enjoy and thank you for all of your support for Resus Now! https://www.ncbi.nlm.nih.gov/books/NBK539856/ http://maryland.ccproject.com/2014/03/11/vascular-access-renal-replacement…
 
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 kno…
 
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…
 
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-catheter…
 
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