#ResusFest - Twitter Hashtag

over 2 years ago

PE is an afterload problem. Hypotension with tachy = cardiogenic shock due to RV strain/failure. Thus giving fluids won’t fix PE spiral of death. PPL who think fluids of 500ml for PE are WRONG. only study of support was in 1999 & not on for massive PE. @srrezaie #resusfest

DeeOptimal's tweet photo. PE is an afterload problem. Hypotension with tachy = cardiogenic shock due to RV strain/failure. Thus giving fluids won’t fix PE spiral of death. PPL who think fluids of 500ml for PE are WRONG. only study of support was in 1999 & not on for massive PE. @srrezaie #resusfest https://t.co/IvNgzxS0ai

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Dr Dee Sanchez @DeeOptimal

over 2 years ago

@ZackRepEM #resusfest Adrenal insufficiency vs adrenal crisis explained in video! AC is like the DKA to diabetes or the thyroid storm to thyroid disorder.

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Dr Dee Sanchez @DeeOptimal

over 2 years ago

@ZackRepEM #resusfest Adrenal crisis defined as adrenal insufficiency in the presence of a stressor. MCC is steroids prescribed. Ex. 5mg/day on prednisone… 1 month to be deficient… but High dose like 40mg/day, steroid source will be depleted in a week!!

DeeOptimal's tweet photo. @ZackRepEM #resusfest
Adrenal crisis defined as adrenal insufficiency in the presence of a stressor.
MCC is steroids prescribed. Ex. 5mg/day on prednisone… 1 month to be deficient… but High dose like 40mg/day, steroid source will be depleted in a week!! https://t.co/FsKiEiBr0m

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Dr Dee Sanchez @DeeOptimal

over 2 years ago

@srrezaie #resusfest Takeaways of norepinephrine use: - No official max dose of norepi but his is 3mcg/kg/min. - start with norepinephrine and once you get to 0.2-0.3mcg/kg/min start vasopressin/hydrocortisone AND assess cause (ie via CT!)

DeeOptimal's tweet photo. @srrezaie #resusfest
Takeaways of norepinephrine use:
- No official max dose of norepi but his is 3mcg/kg/min.
- start with norepinephrine and once you get to 0.2-0.3mcg/kg/min start vasopressin/hydrocortisone AND assess cause (ie via CT!) https://t.co/6KgjRY96AV

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Dr Dee Sanchez @DeeOptimal

over 2 years ago

@srrezaie #resusfest Takeaways of max norepi dose: - highest dose 1.4-2.9 with one case study of 30mcg/kg/min - duration >1mcg/kg/min of max 3-84hours - risk if 5.7-8% digit necrosis - 17-52% survival rate

DeeOptimal's tweet photo. @srrezaie #resusfest
Takeaways of max norepi dose:
- highest dose 1.4-2.9 with one case study of 30mcg/kg/min
- duration >1mcg/kg/min of max 3-84hours
- risk if 5.7-8% digit necrosis
- 17-52% survival rate https://t.co/wiIMhtwjSt

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Dr Dee Sanchez @DeeOptimal

over 2 years ago

@srrezaie #resusfest Takeaway: DO NOT reduce induction agent dose med for fear of hypotension!! No EBM to date that states this is effective! Better to resuscitate before you intubate!

DeeOptimal's tweet photo. @srrezaie #resusfest
Takeaway: DO NOT reduce induction agent dose med for fear of hypotension!! No EBM to date that states this is effective! Better to resuscitate before you intubate! https://t.co/lwsSK3QzYn

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Dr Dee Sanchez @DeeOptimal

over 2 years ago

Search hysteresis: a pacer failure where it tries to fix itself by ventricular pacing only if the spontaneous rate falls below a set rate. @HedayatiMD #resusfest

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Dr Dee Sanchez @DeeOptimal

over 2 years ago

@srrezaie #resusfest “GCS was meant for trauma patients not for medical patients, however we sometimes use it to speak the same language.”

DeeOptimal's tweet photo. @srrezaie #resusfest
“GCS was meant for trauma patients not for medical patients, however we sometimes use it to speak the same language.” https://t.co/z1PO2EnYuW

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Dr Dee Sanchez @DeeOptimal

over 2 years ago

@HedayatiMD #resusfest Takeaways: Hemodynamically stable patients with pneumothorax <35 mm or hemothorax < 300 mL can be safely observed! If you need to provide intervention consider using pigtails instead of a larger tube!

DeeOptimal's tweet photo. @HedayatiMD #resusfest
Takeaways: Hemodynamically stable patients with pneumothorax <35 mm or hemothorax < 300 mL can be safely observed! If you need to provide intervention consider using pigtails instead of a larger tube! https://t.co/fNjFMkbINS

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Dr Dee Sanchez @DeeOptimal

over 2 years ago

Observation only vs intervention approach: Use 35mm Rule = determines chest tube need in penetrating and blunt traumatic pneumothorax. Distance from radial to visceral pleural: <35mm = observation. >35mm = chest tube needed. @HedayatiMD #resusfest

DeeOptimal's tweet photo. Observation only vs intervention approach:
Use 35mm Rule = determines chest tube need in penetrating and blunt traumatic pneumothorax.

Distance from radial to visceral pleural: <35mm = observation.
>35mm = chest tube needed.

@HedayatiMD #resusfest https://t.co/5nctrEi5Fo

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Dr Dee Sanchez @DeeOptimal

over 2 years ago

Summary: 1) Stabilize PRBC to 7g/dl 2) give erythromycin (great for motility) 3) consider octreotide (won’t hurt or make better the situation.) 4) give abs cuz SBP is the source of issue 5) DONT GIVE tranexamic acid in GI bleed! @HedayatiMD #resusfest