Lower Dp/Dt and Blood Pressure
Control Pain with fentanyl
Control Heart Rate/Inotropy with esmolol
See the esmolol drip sheet (YOU MUST CHECK ALL NUMBERS WITH YOUR OWN PHARMACY)
Control Blood Pressure
With in order of preference: clevidipine, nicardipine, nitroprusside, nitroglycerin
What about if the patient can't get beta-blockers?
What about labetalol?
Why is the Patient's Blood Pressure Low?
Andy Neill thankfully addressed my erroneous assumption that MIs in Dissection would only be right coronary infarctions
and check out this article as well (J Emerg Trauma Shock 2011;4:273-278)
Site of Blood Pressure Measurement
Rupture of the Aorta
Do a high-icp/vascular intubation (More to come on this)
- Nicardipine and Esmolol are compatible and can be given through the same IV
Amal Mattu's Law of 4's
- Abrupt onset of Thorax Pain
- Ripping or Tearing
- Migrating Pain
- History of Aortic Problems (like TAA)
- Pulse Deficit
- Neuro Deficit
- New Murmur
Now on to the Podcast…