Today, I put on my head-shrinker cap (it is a fez) and get Cliff Reid on the coach. You know Cliff from his previous podcasts:
- Interview with Cliff Reid: Part I
- Interview with Cliff Reid: Part II
- Cliff's Tips for Occasional Intubaters
- A Discussion regarding NAP4
and his insanely good blog:
Cliff discusses a case of an out-of-hospital cardiac arrest that he has been ruminating about for the past few days. Here are the teaching points that came out of the case:
Can we lyse intra-arrest?
We will discuss this question in a future show. For now, I would say if you strongly suspect PE or MI and you have exhausted other options, intra-arrest lysis is still an option.
The pulse you feel in the groin may be the vein
During the discussion Cliff mentions that he demonstrated to his whole team that the pulse they felt in the groin was the femoral vein. Use ultrasound for all intra-arrest groin catheter placements.
Securing lines during a code
I use 2″ tape. Cliff mentions during the discussion and on his blog, using tissue glue instead.
Continue CPR if there is an a-line pulse, but the pressure is low
Otherwise these patients will just re-arrest. Here is an article on thoracic pump vs. cardiac pump.
Never heard of this? Read this manuscript on percussion pacing.
The Ethics of Different Capabilities at Geographically Close Hospitals
I want to hear what you folks think about this. Should all sick patients be taken to the closest hospital that has the most potential life-saving capabilities? Is there ny reason to bring really sick patients to tiny hospitals if the trip to a more advanced hospital only adds a few minutes? Let me know in the comments what you think.
The Mind of a Resuscitationist – A Resuscitationist Agonizes
This is why I really wanted to post this podcast. I run a series called the Mind of a Resuscitationist. For instance, the episode on
Today's episode hits another key point to a resuscitationist's mind: we agonize. We dissect every case that did not go perfectly to figure out if there was ANYTHING that could have gone better, been done smoother. This obsession leads to ulcers and interrupted sleep patterns AND better outcomes in the future.
Please share your thoughts below. Now, on to the podcast…
- COVID19 – Awake Pronation (aka the Pig Roast) A guest write-up by David Gordon, MD - April 6, 2020
- EMCrit Wee – Webinar I Gave to Pulm/Crit Care Fellows on Avoiding Intubation and Initial Ventilation of COVID19 Patients - April 4, 2020
- EMCrit 269 – Rationing of Critical Care and Ventilators in COVID19 with Reub Strayer - March 31, 2020