CC fellow @UMichAnesthesia @UMichiganEM | Forged by @TamingtheSRU | MCS, HEMS, research | outdoor-iphile, violinist, small town enthusiast | views=my own
First clinical day of fellowship ✅ 🧠 🫀
So happy to be in the ICU again… grateful for the opportunity to learn here at this amazing institution @UMichAnesthesia@umichCVC@UMichiganEM after an amazing education at @TamingtheSRU.
ECMO Puzzle: Can you guess the cannula configuration based on this interesting pattern of fluctuation in the ECMO flow rate?
Why?
A quick 🧵 on some cool 🫁 physiology
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📚.#IABP Focused Review of Physiology, Transport Logistics, Mechanics, & Complications
💡Transport of critically ill pts supported by an #IABP plays an essential role in connecting pts to specialized referral centers.
➡️https://t.co/hOplJk5Do2
@md_SsAhmad
A form of MCS frequently encountered both in-hospital and in the critical care transport environment: the intra-aortic balloon pump🫀🎈
In our @MyJSCAI article, we present the applications, physiology, practical troubleshooting, and transport specifics
https://t.co/bcNHHOsZZ0
In case you were wondering, this what an an elephant mechanical ventilator looks like.
It provides tidal volumes of 25-125 liters
Inspiratory flow rate up to 1,000 lpm
Typical 🐘 vent settings:
RR 5 bpm
TV 80 - 100 liters
Itime 5 seconds
PIP 25 - 30 cmH2O
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I asked the is lady what’s in my hand and she said “pen”.
Correct.
But when I asked her to take it, this is what happened…
Pause and think. What’s happening here
Resus #TEE is ++ valuable for cardiac arrest. It can identify reversible causes, fine VF or pseduo-PEA, guide procedures (ECMO), and improve CPR quality. It also shows how dynamic a resus can be. In this case, CPR being done in what looks like a great position (initially)... a 🧵
Taking a peek at the available equipment on board via #airRx before boarding… curious if anyone has expertise and experience to speak to regarding DNR fulfillment in flight? (Hopefully not speaking this into existence…)
My favorite recent way of creating an easily accessible “parking lot” for what I want to read…. Love using @trello in general, but especially to keep track of what I have read with a little summary, and move each card between boards
Congrats to 128 Grazer, our 2023 #FatBearWeek champion! 🥳 Though unaware of her title in this imaginary contest, her success is real! For bears, fat = success, & she's set up well for winter.
We had a record-shattering 1,382,783 votes! There's so much love for our bears! ❤️
An idea... tell me your take, #medtwitter friends:
Accurate diagnosis is important, but focusing on it during admission to the ICU may be unreasonable due to the fog of resuscitation.
To account for this, yet still encourage the transition from stabilization to diagnosis...
📢 Attention #HEMS & #CCT teams:
@uc_health Air Care & Mobile Care hosting in-person @Abiomed#Impella CCT course in Cincinnati!
Two date options; details & reg:
Fri, 15 Dec: https://t.co/uDkQbjzCZH
Sat, 16 Dec:
https://t.co/sFYrXxVguj
Ping @UCAirCareDoc @HeartRecovery
Excited to share our case series depicting the successful rotor wing transport 🚁of 2 pts supported by dual Impella devices (RP, CP).🫀⚙️ Grateful for such an outstanding team for this project! @karigorder @laertezz @md_SsAhmad @UCAirCareDoc@martina_diazb https://t.co/Cy6448REgf