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Tidal Volume Strategies for those without ARDS
Invasive ventilation is one of the most frequently applied interventions utilized for critically ill patients. However, as with all medical interventions, there are potential risks and harms which must be balanced with perceived benefit. As our understanding of physiology grows, we have found more and more potential harms associated with invasive mechanical ventilation. This review of a recent article published in JAMA explores the impact of different tidal volume strategies for patients who do not have ARDS.
The Head and the Heart: Hemodynamic Derangement in Isolated TBI
We know that alterations in hemodynamics do not only occur in hemorrhagic shock. Both obstructive (such as from tension pneumothorax) and neurogenic shock (for example, from a spinal cord transection), can result in hemodynamic compromise that would not be corrected by blood product administration. There have been some studies that have shown isolated traumatic brain injury (TBI) can also cause hemodynamic derangements. This article looks at a paper which attempts to examine the incidence of cardiovascular instability in patients with TBI.
Cricothyrotomy on HEMS
We train for it, we have a healthy fear of it, and we realize that having to perform one is not an admission of failure on our part. But, how often is a cricothyrotomy performed on HEMS. Dr. Andrew Cathers of University of Wisconsin Med Flight walks through a recently published paper on the topic.