Resus Now

5 Minute Bit #17 - Final Thoughts on Chest Tubes & Pneumothorax

5 Minute Bit #16 - Pneumothorax Imaging Modalities

Please review below articles pertaining to todays show! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC558461/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3299161/

Episode 8 - ED Thoracotomy, Part 2

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 know how to use your spreaders! 4. LOOK!!! 5. Control hemorrhage that is visible and open pericardium-control direct cardiac bleeding 6. Clamp the ao...

Episode 7 - ED Thoracotomy, Part 1

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 and know how to use your spreaders! 4. LOOK!!! 5. Control hemorrhage that is visible and open pericardium-control direct cardiac bleeding 6. Clam...

5 Minute Bit #15 - Chest Tubes and Treatment of Simple Pneumothorax

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-catheters-for-pleural-and-pericardial-drainage/...

5 Minute Bit #14 - Tension Pneumothorax and The Finger Thoracostomy

In this 5 minute bit, we discuss the emergency treatment of the tension pneumothorax using the finger thoracostomy. Please see attached evidence based articles associated with the episode. https://pubmed.ncbi.nlm.nih.gov/22987168/

5 Minute Bit #13 - Intra-Cardiac Arrest Arterial Lines

In this episode Ralph goes over the use of the arterial line in cardiac arrest. Please see below evidence related articles to supplement this 5 minute bit. https://pubmed.ncbi.nlm.nih.gov/4064112/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4087068/pdf/nihms-598128.pdf https://emcrit.org/wp-content/uploads/2018/07/DBP-vs-ETCO2.pdf Below is an excellent blog post and podcast done by Scott Weingart of EMCrit. This clears up where your diastolic value is during mechanical CPR. https://emcrit.org/e...

5 Minute Bit #12 - DKA Series Part 5 - Ralph's Miscellaneous Thoughts on DKA

5 Minute Bit #11 - DKA Series Part 4 - Is My Patient Improving?

Episode 6 - Difficult Airway Series, Part 2

Ralph is joined by Dr. Kelly Wren in a discussion about an anhydrous ammonia spill and the aftermath in the Emergency Department. https://journals.lww.com/em-news/Fulltext/2020/08000/News__Toxic_Gas_Leak_Holds_Lessons_for_COVID_19.8.aspx

5 Minute Bit #10 - DKA Series Part 3 - Which Fluid Do I Choose?

5 Minute Bit #9 - DKA Series Part 2 - Mind The Gap

5 Minute Bit #8 - DKA Series Part 1 - Volume Resuscitation of DKA

Episode 5 - Difficult Airway Series, Part 1

Ralph is joined by Dr. Brock Franklin, who presents an interesting airway case.

5 Minute Bit #7 - A Bloody Emergency- The bleeding tracheostomy

A 5 minute bit on a tracheostomy emergency that deserves some attention. Ralph describes this emergency, the etiology, the recognition, the management steps and prognosis. Please see evidence related articles and sites regarding this topic. https://www.ncbi.nlm.nih.gov/books/NBK482505/ https://emergencymedicinecases.com/tracheo-innominate-fistula/ http://www.downstatesurgery.org/files/cases/tif.pdf...

Episode 4 - Emergent Treatment of Rapid A-Fib & A-Flutter

Emergent treatment of rapid atrial fib/flutter with Dr. Dave Zull. Please see below for Evidence based annotated articles Arrigo M. New Onset Atrial Fibrillation in critically ill patients and it’sassociation with mortality. Int J Cardiol 266:95-99, Sept 2018 Bosch, NA, et al. Atrial Fibrillation in the ICU CHEST 154:1424-1434. Dec 2018 Nice review of A fib in the critically ill patient. Emphasis first on correcting precipitants like sympathomimetics, electrolytes, volume and intercurrent illnes...

5 Minute Bit #6 - Avoiding Central Line Complications

A 5 minute bit that discusses the feared complication of inadvertent arterial placement of central lines. We discuss some strategies to avoid this and other complications. We use ultrasound for needle insertion (even for subclavian lines), tube manometry, guidewire localization with ultrasound, and the agitated saline test using POC echo at the bedside. Please see below evidence based articles, blogs and pictures associated with the show. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296410/ htt...

Episode 3 - Cardiac Arrest with ROSC: Who Goes to the Cath Lab?

Dean Ferrera MD, Interventional Cardiologist visits Resus Now to discuss which post arrest ROSC patients without a STEMI on the EKG should go to the cath lab. Please see below for evidence related articles related to the show. https://www.nejm.org/doi/full/10.1056/ https://wikem.org/wiki/STEMI_equivalents

5 Minute Bit #5- The Bleeding AV Fistula

In this 5 minute bit, Ralph discusses some methods of managing a patient with a bleeding AV fistula. Sorry, we ran way over 5 minutes........Hopefully it’s worth it. a Show Notes: Suture required is usually 5.0-6.0 prolene with a non cutting needle. Don’t forget local anesthesia. https://www.acepnow.com/article/dialysis-access-emergencies/ https://emblog.mayo.edu/2015/04/27/how-to-stop-a-post-dialysis-site-bleeding/ https://i1.wp.com/rushemergencymedicine.org/wp-content/uploads/2019/03/Cutting-v...

5 Minute Bit #4- Every Kiss Begins With K(etamine)

https://link.springer.com/article/10.1007/s12028-013-9950-y https://pubmed.ncbi.nlm.nih.gov/24996763/

Episode 2 - Airway Management Part 2: The Drugs of RSI

In this episode, Ralph & Dr. Barker discuss the different drugs available for RSI. Evidence based articles related to our topics, click links below: https://coreem.net/core/parenteral-benzodiazepines/ https://link.springer.com/article/10.1007/s12028-013-9950-y https://pubmed.ncbi.nlm.nih.gov/24515638/ https://www.uptodate.com/contents/induction-agents-for-rapid-sequence-intubation-in-adults-outside-the-operating-room https://emj.bmj.com/content/22/6/456 https://emedicine.medscape.com/article...

5 Minute Bit #3 - Nurses Roundtable

Ralph brings in some of his favorite ER nurses to voice their complaints about ER providers.

5 Minute Bit #2 - Push Dose Pressors

In this 5 minute bit, Ralph goes over a few options that you have for push dose pressors. Questions? Email us at ResusNowQuestions@gmail.com Please click on the links below for evidence related to this topic https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5052865/pdf/ceem-15-010.pdf http://www.emdocs.net/push-dose-vasopressors-an-update-for-2019/ https://www.tandfonline.com/doi/abs/10.1080/10903127.2019.1588443?journalCode=ipec20 https://emcrit.org/wp-content/uploads/2017/08/holden-push-dose.pdf ht...

Episode 1 - Airway Management, part 1

The long awaited first episode of Resus Now! This episode is the first in our multipart series on Airway Management. Questions? Email us at ResusNowQuestions@gmail.com Resus Now- episode 1- Airway management-part 1 show​ ​notes 1. Talk about preparing to intubate a patient, gathering equipment, assigning roles, back up plans for failure 2. Basic equipment needed in EVERY intubation- preOX equipment= BVM w/ PEEP valve, NC at 15 LPM, suction that works, Monitor, BP cuff, pulse ox, capnography, IV ...

5 Minute Bit #1 - Welcome to Resus Now!

Welcome to Resus Now! This 5 minute bit serves as an introduction to our concept and gives some background on our philosophies. Welcome!