Crics, Critical Access, and Critical Care with Scott Weingart
Nov 25, 2022
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Emergency medicine physician Scott Weingart discusses procedural competency, stress mitigation, critical access, and skillset decay. Topics include managing stress during critical situations, establishing specific roles in resuscitations, advanced airway management techniques, and monitoring peak pressure levels in patients.
Effective stress mitigation techniques are critical for maintaining composure during high-stress scenarios like cricothyrotomy.
Regular mental or physical practice of rare but crucial procedures with the team enhances preparedness and teamwork even in a community setting with turnover challenges.
Deep dives
Stress Mitigation and Preparedness for Critical Procedures
Maintaining composure in high-stress scenarios like cricothyrotomy requires effective stress mitigation techniques. Techniques like self-talk, controlled breathing, and grounding oneself can help individuals navigate tense situations. Regular mental or physical practice of rare but crucial procedures with the team enhances preparedness and teamwork, even in a community setting with turnover challenges.
Stages and Techniques of Cricothyrotomy
The successful execution of cricothyrotomy marks a critical achievement. Key considerations include equipment preparation, choice of the laryngotomy blade, and technique during the procedure. Specific techniques such as the stab incision with a 10 blade and using tactile confirmation for tracheal insertion play vital roles in a successful cricothyrotomy.
Recognizing the Need for Escharotomy
The need for escharotomy in burn patients becomes apparent through ventilator alarms indicating chest wall restriction. Peak pressure alarms and diminishing tidal volumes signal the requirement for intervention. A surgical airway is considered when ventilatory support becomes compromised due to circumferential burns, typically indicated by peak pressures around 40-50.
Navigating Challenging Medical Scenarios
Dealing with critical medical cases demands quick thinking, teamwork, and adaptability. Handling delayed transfers, equipment shortages, and resuscitation complexities requires a blend of clinical expertise and interpersonal skills. Successfully managing such challenging scenarios reflects effective coordination, decision-making, and medical acumen to ensure patient well-being.
We sat down with the great Scott Weingart of the EMCrit blog and podcast (@emcrit) to talk about the toughest case I ever managed. The conversation covers procedural competency, stress mitigation, skillset decay, critical access, critical care, and a whole lot more.
Check out our podcast page for the full transcript.