Enjoy this week’s Grand Rounds Recap! Dr. Jordan Bonomo started us off with a fascinating talk on brain death, and how therapeutic hypothermia in the post-arrest patient can make this diagnosis more challenging. Next up, Dr. Harrison taught us some pearls on management of the bradycardic peri-arrest patient. Dr. Nagle shared with a us how to rescuscitate a patient with acute aortic dissection. Lastly, Dr. Summers talked to us about PRES and how to recognize and treat this rare disorder.Read More
The final Grand Rounds for the 2017-2018 academic year opened with a fantastic morbidity and mortality conference given by Dr. Ludmer. Dr. Randolph then gave us his approach to the dyspneic and hypoxic patient. Thanks for following us through this enriching and amazing year of education!Read More
Morbidity and Mortality Learning Points with Dr. Stull
1. Should Post-ROSC patients get cardiac cath?
- Cardiac arrest patients who have STEMI on EKG after ROSC tend to have good outcomes (overall survival and intact neurologic survival) if they get cath'ed.
- According to latest Australian study (all patients with ROSC from OHCA, not STEMI) OR for overall survival is 2.77 and OR 2.2 for good neurologic outcome
- VT/VF cardiac arrest patients who do not have a STEMI on EKG: improved survival and likelihood of good neurologic outcomes if cath'ed within 24 hours.
- Our cardiology department wants all post-ROSC VF/VT patients to have cath lab activation. All other post-ROSC cases, call cardiology to discuss need for cath lab
- All post-ROSC STEMI should go to cath lab no matter what their neuro status is