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Shyam Murali
Fellow in Trauma and Surgical Critical Care - University of Pennsylvania,
Senior Editor - CriticalCareNow.com,
Writer - RebelEM.com,
Saxophonist, EDM remixer, husband, puppy father, and new human father
For some spaced repetition, here’s a review of this week’s content:
Intubating Oral Airways by Terren Trott
- Intubating oral airways facilitate fiberoptic intubations by creating a channel to the cords
- Different brands have different qualities with pros and cons
Prehospital TXA for TBI: Does it Live up to its Hype? by Mohamed Hagahmed
- This trial showed that giving TXA within two hours of injury to patients with moderate to severe TBI in the out-of-hospital setting did not result in significant neurologic benefit at 6-month follow-up. In my practice, I would continue giving TXA to patients who present with head injury and hemorrhagic shock.
VV-ECMO 101: Going “On Pump” for Acute Pulmonary Failure by Fraser Mackay
- VV-ECMO is a branch of ECLS that provides supplementary gas exchange for reversible pulmonary disease.
- VV-ECMO is not for the chronically ill or for those with multi-organ failure. It’s best used early in otherwise healthy patients with devastating single-organ failure.
- With judicious patient selection and multidisciplinary support, it represents an important salvage modality for those suffering from pulmonary failure.
Rad Review Episode 7: Code Blue MRI by Rupal Jain
- Pearl #1: The Magnet is ALWAYS ON!
- Pearl #2: Never attempt to run a code in Zone 4, or the magnet room. The patient will be moved to a predetermined magnetically-safe area, or Zone
- Pearl #3: MRI Emergency Quench (turning off the magnet) is super rare and is only done in true emergency situations such as if a subject is pinned within or against the magnet or if there is a fire within the gantry that cannot be extinguished.
The Vitals: Priorities in Cardiac Arrest Part 2 by Shyam Murali
After high-quality chest compressions and early defibrillation have been addressed, the next priorities in cardiac arrest are:
- Obtain a history
- Establish vascular access
- Determine which meds need to be given and administer them
- Begin basic airway maneuvers and consider whether you need an advanced airway
- Treat the reversible causes of cardiac arrest
Management of Organ Donors After Brain Death (Part 1) by Nishika Patel
- There is no universal set of guidelines on how to manage organ donors after brain death.
- Donors often require medications such as those listed above to optimize their organs for transplant.
- Contact your local organ procurement team for assistance on medication selection and dosing.
