Tamingthesru
Lessons in Transport - TXA has Arrived!!
To successfully resuscitate the critically ill trauma patient we must have an understanding of and a respect for the LETHAL TRIAD of TRAUMA...
Bleeding causes acidosis, coagulopathy, and hypothermia...
Acidosis and hypothermia causes more coagulopathy which causes more bleeding... and so begins a deadly cycle
Lessons in Transport - Therapeutic Hypothermia Part 3
Common Issues in Therapeutic Hypothermia
1) Bradycardia: may occur during induced hypothermia (even to as low as 35 bpm) and except in rare cases, is NOT a reason to discontinue hypothermia.
- If bradycardia is severe, associated with persistent hypotension, and is not responsive to fluid and vasopressor therapy, a decision in conjunction with medical control to discontinue hypothermia may be made.
2) Dysrhythmias: generally does not occur unless temperatures fall < 30*C and hypothermia related ventricular fibrillation is rare unless temperature is < 28*C.
Transvenous Pacemaker Insertion - Part 3
We used Part 1 and Part 2 in this series to give you an in depth understanding of all the critical steps of the procedure. After reading those posts you should have a good grasp of the indications for the procedure, the complications you may encounter, and you will have read, seen, and heard step by step instructions for placing a transvenous pacemaker in the ED. This final installment in the series should bring it all together for you. Here you will see the placement of the transvenous pacemaker from start to finish from the point of view of the operator (Dr. J'Mir Cousar) all filmed in glorious HD.