
Coda Change Cartner, Michaela— Cardiac Surgery... then Cardiac Arrest
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Dec 23, 2014 Michaela Cartner, an intensivist at the Gold Coast, shares her expertise in managing cardiac patients post-surgery. She dives into the systematic approaches to shock management, emphasizing the need to monitor cardiac output and rhythms closely. The conversation also addresses the complexities of handling cardiac arrest situations, highlighting the critical protocols for intensive care, internal compressions, and the importance of emergency kits. Cartner's insights provide a thorough look at the challenges and nuances of cardiac care.
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Systematic Approach to Shock
- Always start shock assessment with airway and breathing checks before moving to circulation.
- Analyze cardiac output by examining heart rate and rhythm, then adjust with appropriate medications or pacing.
Right Heart Physiology Insight
- The right heart's function is heavily influenced by oxygen levels, CO2, and acid-base balance.
- Treating right heart issues requires balancing oxygenation and afterload manipulations carefully.
Left Ventricle as Pressure Pump
- The left ventricle behaves like a pressure pump, tolerating pressure well, unlike the flow-adapted right ventricle.
- Positive end-expiratory pressure (PEEP) helps the left heart push blood forward, enhancing its function.
