ResusX:Podcast

In this episode, Dr. Haney Mallemat delves into the critical role of ultrasound in cardiac arrest scenarios, emphasizing its potential to uncover reversible causes. Tracing the historical evolution of resuscitation techniques from the 1500s to modern times, he highlights the limitations of traditional methods like pulse checks. He stresses the importance of incorporating ultrasound for accurate diagnosis and effective resuscitation. Dr. Mallemat provides insights into the challenges and benefits of using ultrasound during cardiac arrest, offering practical tips to optimize its utility without compromising chest compressions. Furthermore, he explores the future of ultrasound in resuscitation, particularly the promising prospects of transesophageal echocardiography (TEE). With a focus on clinical understanding and technological advancements, Dr. Mallemat advocates for a comprehensive approach to resuscitation, leveraging ultrasound as a powerful adjunct to enhance patient outcomes.

In this episode, Dr. Rory Spiegel introduces the concept of micropuncture kits, describing them as the "Swiss Army Knife" of vascular access. He highlights the versatility and advantages of using smaller gauge needles, introducer sheaths, and straight tip wires for vascular procedures. Dr. Spiegel emphasizes the improved control, ease of use, and added safety of micropuncture kits, encouraging healthcare professionals to explore their benefits in central and arterial line placements.

Dr. Zaf Qasim provides a comprehensive overview of REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) at the ResusX: Reset Conference in this episode. He discusses its significance in trauma management, its evolution from conventional methods like thoracotomy, and its potential complications. Dr. Qasim highlights the ongoing research, including a trial comparing REBOA to standard care, and emphasizes its role in addressing torso hemorrhage, including postpartum situations. He also explores advancements in REBOA techniques and technology, underscoring its continued importance in saving lives despite challenges and criticisms.

In this episode, Dr. George Willis discusses the critical diagnosis and management of aortic dissection, emphasizing the importance of considering it in patients presenting with chest, back, and abdominal pain. Drawing from a case scenario and clinical experience, Dr. Willis highlights the challenges in diagnosing and managing aortic dissection, particularly when patients deteriorate rapidly. He provides practical insights into using ultrasound for diagnosis, the significance of resuscitation before intubation, and the cautious approach to pericardiocentesis. The episode underscores the necessity of early recognition and intervention to optimize patient outcomes in this high-stakes emergency.

In this ResusX Podcast episode, Dr. Tarlan Hedayati discusses the ongoing debate surrounding airway management during cardiac arrest, exploring the effectiveness of endotracheal intubation, supraglottic airways, and bag-valve-masks. Drawing from recent studies and meta-analyses, Dr. Hedayati emphasizes the importance of prioritizing CPR and shares insights into selecting the most suitable airway intervention based on the patient's condition and available resources. Tune in to gain a comprehensive understanding of the latest evidence-based practices in cardiac arrest management.

In this podcast episode, Dr. Eddy Gutierrez explores innovative approaches to treating Septic Shock with Hydroxocobalamin and Methylene Blue. Emphasizing the need for unconventional strategies due to high mortality rates with current treatments, he discusses the mechanisms of these medications in addressing the overdrive of the immune system in Sepsis. Methylene Blue, with a history dating back to the 1800s, is highlighted for its role in inhibiting inducible nitric oxide synthase and soluble guanylyl cyclase. The "SHOCKEM - Blue" trial results are discussed, indicating benefits such as faster discontinuation of vasopressors and reduced ICU length of stay. Dr. Gutierrez also delves into Hydroxocobalamin, a vitamin B12 variant, sharing findings from a recent Phase 2 study showing promising catecholamine sparing effects. Despite potential side effects, the cost-effectiveness of these treatments is considered, and ongoing clinical trials suggest a growing interest in exploring these mechanisms for Septic Shock management.

In this episode, Dr. Mohammed Hagahmed discusses the critical management of a patient presenting with suspected pulmonary embolism (PE) and right ventricular failure in the emergency department (ED). Highlighting the importance of optimizing resuscitation before intubation, he emphasizes strategies to address hypotension, optimize preload, and improve myocardial contractility while avoiding systemic hypotension. Dr. Hagahmed shares practical insights on medication choices, ventilatory settings, and the significance of careful patient monitoring, aiming to equip healthcare providers with essential knowledge for managing such high-risk cases effectively.

In this podcast episode, Dr. Steve Haywood addresses crucial aspects of using a ventilator in emergencies, emphasizing the significance of the PEEP valve. Dr. Haywood underscores the common misuse of PEEP valves, debunking misconceptions and shedding light on their essential role. He guides listeners through the steps of optimizing oxygen delivery, from ensuring proper oxygen connection to highlighting the importance of a Pressure Manometer. Additionally, he advises maintaining continuous monitoring using Waveform End-Tidal CO2, debunking traditional colorimetric indicators. Dr. Haywood's insights provide valuable knowledge for healthcare professionals dealing with acute patient scenarios, offering practical tips for effective ventilator use and patient care.

In this podcast episode, Dr. Salim Rezaie explores the intriguing topic of norepinephrine dosage in critical care, asking "Norepinephrine: How High Can You Go?" After posing the question to the ResusX community, he delves into four retrospective studies and a unique case report, shedding light on the highest recorded doses ranging from 1.4 to 2.91 micrograms per kilogram per minute. With a lack of randomized clinical trials on maximum dosage, Dr. Rezaie discusses survival rates, digit necrosis, and the duration of high doses. Emphasizing the rarity of such instances, he offers insights into assessing patients, suggesting considerations like accurate blood pressure measurement, echocardiography, and source control. Dr. Rezaie encourages critical evaluation during escalating doses, sharing his clinical approach and stressing the importance of recognizing underlying causes. This episode serves as a thought-provoking exploration of norepinephrine limits in critical care, sparking valuable debate and conversation within the medical community.  

In this podcast episode, Dr. Rory Spiegel discusses the challenges of breathing, particularly in cases of wet, heavy lungs and increased dead space. The focus shifts to APRV (Airway Pressure Release Ventilation) as a mode of ventilation and its benefits in returning patients to Functional Residual Capacity (FRC). Dr. Spiegel emphasizes the importance of understanding FRC in the context of ARDS (Acute Respiratory Distress Syndrome) and dispels myths surrounding APRV. He delves into the physiological aspects, including the viscoelastic nature of the lung and the impact on dead space. The episode concludes by highlighting the practical goal of maintaining patients at FRC for improved outcomes, touching on aspects like heart function, sedation, and reduced barotrauma.