Nanette Matos

Emergency Medicine Resident @NorthwellHealth
All opinions are my own

[Nanette Matos @nm_tomato]

TEE in Cardiac Arrest
Mid-esophageal 4 chamber
- counterpart to TTE apical 4 chamber
- reversible causes of arrest
- LV/RV function
Mid-esophageal long axis
- counterpart to TTE parasternal long
- assess quality of CPR
- LV function
@ryangibbonsEMUS @CriticalCareNow #ResusX2022

[Nanette Matos @nm_tomato]

Reasons to use POCUS in cardiac arrest
- look for reversible causes of cardiac arrest
- femoral & carotid pulse checks can be unreliable
- pseudo PEA
- U/S guided procedures
@DanPatino7 @CriticalCareNow #ResusX2022

[Nanette Matos @nm_tomato]

Next up for the #ResusX2022 breakout sessions Dr. Ryan Gibbons @ryangibbonsEMUS discussing TEE in Arrest @CriticalCareNow

[Nanette Matos @nm_tomato]

What about Esmolol? Beta1 selective and short-acting, thought to counteract circulating catecholamines @tsquaredmd @CriticalCareNow #Resusx2022

[Nanette Matos @nm_tomato]

Epinephrine in refractory vfib? -> overactive catecholamine release -> Increased myocardial O2 demand, ischemia, and depression of VF threshold @tsquaredmd @CriticalCareNow #Resusx2022

[Nanette Matos @nm_tomato]

Refractory V-fib: continued fibrillation after 3 defibrillation attempts plus 1 antiarrhythmic agent @tsquaredmd @CriticalCareNow #Resusx2022

[Nanette Matos @nm_tomato]

What about PCI? ECGs right after ROSC may result in false positive STEMI activation. Always worth repeating the ECG while talking to interventional cards if there is uncertainty @critcareguys @CriticalCareNow #Resusx2022

[Nanette Matos @nm_tomato]

It can be very difficult to recognize nonconvulsive seizure activity post arrest. EEG should be done in patients who remain comatose after ROSC @critcareguys @CriticalCareNow #Resusx2022

[Nanette Matos @nm_tomato]

How do we accomplish this? Maintaining adequate oxygenation/ventilation, optimizing MAP, TTM, detection of seizures, and PCI if indicated @critcareguys @CriticalCareNow #Resusx2022

[Nanette Matos @nm_tomato]

Post cardiac arrest there are two main goals: 1) Optimize neurologic resuscitation 2) Prevent secondary injury @critcareguys @CriticalCareNow #ResusX2022

[Nanette Matos @nm_tomato]

It doesn’t stop with ROSC. Next up is Dr. Mike Winters on Post-Arrest Interventions that Matter @critcareguys @CritCareNow #Resusx2022

[Nanette Matos @nm_tomato]

Facilitating a culture of excellence during a code is paramount. Everyone has a role and a clear plan is formed quickly. @drbellezzo @CriticalCareNow #ResusX2022

[Nanette Matos @nm_tomato]

Zero to Bypass in 6 minutes with
@drbellezzo
When rushing to cannulate for ECMO remember Festina Lente AKA Slow is smooth, smooth is fast
@CriticalCareNow #ResusX2022

[Nanette Matos @nm_tomato]

Zero to Bypass in 6 minutes with @drbellezzo When rushing to cannulate for ECMO remember Festina Lente AKA Slow is smooth, smooth is fast @CriticalCareNow