Courtney

Does pulse strength correlate with blood pressure? The short answer is no. We looked at over 22,000 measurements with a blood pressure documented along with pulse strength. The numbers were pretty much all over the map with little reliability for estimating the blood pressure. If you want a blood pressure, then check a blood pressure. academic.oup.com/milmed/arti… #emergency #emergencymedicine #criticalcare #icu #erlife #iculife #science #data #research #army #armymedicine #armyemdoc #trauma #medx #medtwitter

A new systematic review with meta-analysis on preoxygenation methods before emergency intubation came out last month. Bottomline: Oxygen masks are 🗑 we should not be using them. We should be reaching for NIV or HFNC -- both of which are viable options based on current RCT data. -11 trials, nearly 2900 patients -NIV and HFNC were both superior to BVM and standard oxygen mask -Unclear whether NIV versus HFNC is superior -Of note, our #PREOXI trial made up almost half of the patients in this meta-analysis -There was a weak trend towards favoring NIV over HFNC, but the data is not sufficient to state that one should be used over the other frontiersin.org/journals/med… #emergency #emergencymedicine #criticalcare #icu #erlife #iculife #science #data #research #army #armymedicine #airway #medx #medtwitter

Listen to this termination of resuscitation… which is how it should happen. There are several things to note that Dr. Robby from The Pitt did here that are spot-on. 1. He, in no uncertain terms, told her parents that her cardiac arrest was non-survivable. This is not the time to list out percentages or probabilities. This is the time to provide certainty to the inevitable death. 2. He told the parents when the appropriate time was to terminate resuscitation. Notice… No one said, “hey, so, do you want us to keep going or what?”. When a statement like that or similar is used, what the family hear are, “so… do YOU want to let granny die now or what?” You, the medical professional, that understands physiology and abysmal outcome even if ROSC is achieved at this point should be the one bearing the burden of making that decision, not the family member. 3. He offered to allow the remaining family to come in before stopping all of the visible efforts of resuscitation. (see previous post on this topic) My general gist is something like this, “Johnny has had no pulse and no blood flow to the brain for 40 minutes. Even if all the things we are doing were to get his heart beating again, he has suffered permanent brain damage. He will never wake up and be the same person you’ve him as. Now is the appropriate time to stop.” More to come on potassium levels and cardiac arrest... #emergency #emergencymedicine #criticalcare #icu #erlife #iculife #science #army #armymedicine #armyemdoc #resuscitation #research #data #family #death #cpr #medx #medtwitter