Night shift tidbit: Use surgilube/lubricating jelly to take dried blood RIGHT off skin! Don't irritate the skin like scrubbing with H2O2 and a washcloth. #FOAMed #nursetwitter

@WhismanSucks @NailedIt @nicolebyer Yassssssss!!!!!

Non-tamponade effusions: -post-procedure -> rapid worsening -infections -malignancy -radiation -> constrictive cardiomyopathy @brianjwrightmd #Resusx2022

Tamponade Effusion & tamponade are a SPECTRUM, not B&W. Ddx: pulsus paradoxus >10-15, plethoric IVC, ECHO pulsus paradox, RA systolic collapse, RV diastolic collapse Peri-arrest = LV diastolic collapse @brianjwrightmd #Resusx2022

RT @DeeOptimal: The biggest takeaways: - 4 parts of of TEG you need to focus on: - FFP = Factor; Fibrinogen; Platelets - UP UP DOWN DOWN =…

RT @Cont2Monitor: Restoration of blood flow after an OMI is obviously critical, but the before and after pictures are art! #ResusX2020 @Bra…

TC Pacing-> Any unstable bradyarrhythmia -this is JUST a introducer, choose RIJ -Use a CONDOM- sterile sheath is a MUST -Initial: V pace/80 rate/25mAmp/Asynch -Capture (STEMI/OMI pattern) -The turn down- x2 mAmp capture is lost is where to leave it! @CgMack31 #ResusX2022 #FOAMed

SCAD Treatment options: ASA, angiography, Beta/calcium channel blockers -- Do NOT: anticoag, thrombolytics, PCI/CABG #ResusX2022 #FOAMed

Conditions associated with SCAD (spont coronary artery dissection) 😱 - connective tissue disorders - pregnancy - post-partum period - multiparity - exogenous hormones (OCPs) #ResusX2022 #FOAMed

ST elevation besides Ischemia = LEAPS L - LVH, LBBB E - early repol, epi, electricity A - aneurysm (LV), thoracic aortic diss. P - pericarditis, PE, potass S - shock states, SCAD #ResusX2022 #FOAMed

RT @Cont2Monitor: Not every shock is septic. Think cardiogenic with the below factors #ResusX2022 @CgMack31

Cardiogenic shock: first find it, use ECHO! MI VS HF? -Inopressors BEFORE inotropes- NOREPI -Inotropes if not improved -> Dobut (new) VS milrinone (established failure) -Inotropes fail? Go mechanical. IABP->Impella->VA-ECMO? @CgMack31 #ResusX2022

Unstable AF ?s 🫀Primary or secondary 🫀Rate VS rhythm- need an atrial kick? 🫀Cardioversion 🫀Sympathetic state- precedex 🫀Lytes, replace K/Mg first 🫀Fluid status, not too much/little 🫀Drugs - HoTN(neosyn)/rate & rhythm(amio) @SaraCrager #resusX2022

Valvular Disasters: aortic stenosis -preload dependent -tx dysrhythmias -pressors - phenylephrine, no effect on heart rate -inotropic support -> surgery @HedayatiMD #ResusX2022

Valvular disasters: Aortic Regurg -diuresis -afterload reduction -support rate, keep in 110-120s -easy pressors -inotropic support -> CT surgery! @HedayatiMD #ResusX2022

Valvular Disasters: Mitral Regurg -diuresis -afterload reduction -pressors + inotropes (PRN) -tx afib -> cath lab VS OR @HedayatiMD #ResusX2022

If you MUST intubate an asthmatic.. -Vent can fix trapping, NOT the obstruction -TV 6-8mL/kg -RR 8-12 -I time 0.8-1.0s -PEEP 0-5 -Peak pressure limit 60-80 Avoid incomplete exp Tolerate hypercapnia (pH >7.2) @SkylerLentz #ResusX2022

RT @smuramed: Check out @drlauraduggan joining us from the hospital operating room for #ResusX2022 between cases! THIS is commitment to edu…

Scapel. Finger. Bougie. The hardest part of a cric is the decision to cut, not the procedure itself. 2 cuts = 3cm vertical + stab/twist horizontal @srrezaie @REBEL__EM #ResusX2022

Awake Intubation! Make the airway compliant without relying on sedation 🫁 glycopyrrolate 🫁 3-4% lidocaine nebulized, atomized 🫁 5% lidocaine paste popsicle Have the patient test for their own gag reflex using a yankauer! @drlauraduggan #ResusX2022 #FOAMed