ResusX:Podcast

In this gripping episode of "A Curious Case" with Dr. Swaminathan and Dr. Hedayati, the hosts delve into a real-life medical case involving a 35-year-old woman with severe postabortion hemorrhage. The patient's critical condition is vividly described, prompting a detailed discussion on managing such emergencies. They emphasized key aspects such as early recognition, vital signs monitoring, and the importance of a collaborative approach. They walk through the use of uterotonic medications, the initiation of a Massive Transfusion Protocol, and the challenges of dealing with limited resources. The episode provides valuable insights into the complexities of postabortion hemorrhage cases, offering practical tips for healthcare professionals faced with these challenging scenarios. 

In this episode of the podcast, Dr. Max Hockstein, an Emergency Physician and Intensivist, delves into the intricacies of End-Tidal Capnography. The discussion covers the terminology surrounding this topic, its significance in understanding Minute Ventilation and Cardiac Output, and the concept of VQ matching in the lungs. Dr. Hockstein explains the working principles of modern End-Tidal measurement, including Non-Dispersive Infrared Absorption, and distinguishes between sidestream and mainstream Capnometry. The episode explores the phases of a Time Capnogram and the utility of End-Tidal in various medical scenarios, from intubation confirmation to resuscitation and preload responsiveness. The episode offers valuable insights into this critical aspect of medical monitoring and leaves listeners eagerly anticipating act two.  

In this episode of End-Tidal Act 2, Dr.Max Hockstein delves into a series of intriguing medical cases by analyzing Capnograms. These waveforms offer a unique window into respiratory and cardiac conditions, presenting challenges such as ventilator dyssynchrony, low cardiac output, and the distinctive Curare Cleft. The discussion covers scenarios like Endotracheal Tube Dislodgement, the Pigtail phase indicating poor compliance, and the classic shark fin appearance denoting obstruction. Max explores counterintuitive insights into Emphysema and highlights the distinctive Capnogram of a Single Lung Transplant. The episode concludes with a fascinating exploration of Cardiogenic Oscillations, where a large heart's pulsations influence lung CO2 levels. The audience gains valuable insights into critical care scenarios, making this episode a must-listen for healthcare professionals and enthusiasts alike.

In this episode, Dr. Mohammed Hagahmed, a faculty physician at the University of Pittsburgh Medical Center, shares a compelling case of a patient named Miss Z, a recent immigrant with COPD. Dr. Hagahmed discusses the challenges of caring for crashing patients, focusing on the critical importance of peri-intubation resuscitation. He delves into factors that can lead to peri-intubation cardiac arrest, such as hypoxemia, hypotension, and high shock index. He also discusses the choice of sedation and paralytic agents, emphasizing the need to ensure appropriate sedation when intubating patients. Dr. Hagahmed provides valuable insights into managing these high-risk scenarios and the latest research findings on the topic.

In this podcast episode, Dr. Evie Marcolini discusses a real case involving a 72-year-old patient who experienced a biking accident. The patient's condition raises important questions about managing blood pressure in neuropatients. Dr. Marcolini emphasizes the significance of tailoring blood pressure goals to the specific condition a patient is suffering from, be it Traumatic Brain Injury or Hemorrhagic Stroke. She underscores the need to maintain Cerebral Perfusion Pressure, highlighting the importance of individualized care based on the patient's health history. The episode also touches on various medical considerations, including the use of medications like fentanyl and the role of hydration in ensuring safe intubation. Ultimately, Dr. Marcolini's message is that thoughtful and well-informed blood pressure management can significantly impact patient outcomes.

In this episode, Dr. Sara Crager discusses the complexities of selecting vasoactive medications, known as "pressors," for patients in shock. She emphasizes the importance of not just memorizing tables but understanding the underlying principles of why, when, and which pressor to use. Dr. Crager points out the limitations of relying solely on evidence-based medicine for such decisions, highlighting the uniqueness of each patient and the importance of considering provider expertise. She explores various factors, including the need for vasoconstriction, vasodilation, increased inotropy, and concerns about side effects like arrhythmias and pulmonary pressures, to guide the thoughtful selection of the most suitable pressor or combination of pressors to improve tissue perfusion in shock patients.

In this podcast episode, Dr. Abhilash Koratala from the Medical College of Wisconsin provides a comprehensive overview of VEXUS (Venous Excess Ultrasound), a valuable tool for assessing a patient's hemodynamics and fluid status at the bedside. Dr. Koratala explains the three key components of evaluating the hemodynamic circuit, which includes Forward Flow, Fluid Responsiveness, and Backward Pressures of the heart. He emphasizes the importance of assessing Systemic Venous Congestion and its impact on organ perfusion, particularly the kidneys. VEXUS combines various ultrasound parameters, including Inferior Vena Cava, Hepatic Vein, Portal Vein, and Intrarenal Vein, to quantify venous congestion and predict the risk of organ injury. The podcast also includes practical insights and case examples of how VEXUS can guide treatment decisions and monitor patient response to therapy.

In this episode, Dr. Laura Duggan, an Associate Professor in the Anesthesia Department in Ottawa, delves into the complexities of traumatic airway management. Dr. Duggan emphasizes the importance of combining opinions and evidence to provide the best patient care. She highlights the challenges of maintaining airway management skills and the shift toward evidence-based decision-making. Dr. Duggan also discusses the risks associated with blunt and penetrating airway trauma, the significance of assessing the mechanism of injury, and the value of visualizing both above and below the glottic entry during intubation. She encourages collaborative efforts between specialties and the use of nasopharyngoscopy for assessing airway trauma while stressing the importance of teamwork in critical situations. Check out ResusX for more from Laura and our other amazing faculty!

In this lively podcast debate from ResusX:ReVolved, Salim Rezaie and Anand Swaminathan tackle the contentious topic of Mechanical versus Manual CPR. Swaminathan, also known as "The Swami," begins by arguing against Mechanical CPR, asserting that there is no compelling high-quality evidence to support its superiority over Manual CPR. He emphasizes the critical importance of high-quality CPR and early defibrillation in achieving good neurologic outcomes in cardiac arrest cases. Swaminathan raises concerns about the obstacles, costs, and training required for Mechanical CPR devices, suggesting that they may not be justified in many settings. He concedes, however, that there might be a role for these devices in scenarios with limited rescuers or prolonged transport times. Rezaie, "The Rebel," counters by acknowledging their shared belief in the significance of compressions and defibrillation but argues that humans often struggle to maintain the quality of compressions. He highlights the potential cognitive offload that Mechanical CPR offers and cites a meta-analysis that found no significant difference in outcomes between Mechanical and Manual CPR. Rezaie also mentions scenarios where Mechanical CPR could be particularly beneficial, such as in ECMO/eCPR cases and scenarios with limited personnel. The debate leaves the audience with plenty to ponder regarding the use of Mechanical CPR devices in cardiac arrest management.

In this captivating podcast episode, Dr. Joe Bellezzo, an ER physician from San Diego, shares their groundbreaking journey of integrating ECMO into their Emergency Department for Refractory Ventricular Fibrillation cases. Beginning with his inaugural case involving a patient named Ralph, the episode explores the transformation of ECMO from a tool designed for surgeons to a life-saving ER procedure. Dr. Bellezzo emphasizes the significance of deliberate movements in critical situations, drawing parallels to motorcycling's "whiskey throttle" concept. The episode also highlights their shift towards a culture of resuscitation excellence, driven by remarkable survival stories, and introduces the concept of "Code Choreography" to optimize resuscitation procedures. Tune in to witness how innovation and dedication have reshaped emergency medical practices, propelling the possibilities of meaningful survival. Don't forget to register for the ResusX:Reset conference, live in Philadelphia or virtual (https://www.resusx.com/Reset)