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The Unstable Bradycardias
What do you do when a patient's heart rate is plummeting and you're the only one standing between them and disaster? In this lecture from the ResusEM6: The Broken Heart Conference (see the link below for more lectures), Dr. Kim Chavez walks you through the essential steps for managing unstable bradycardia.
From initial assessment to understanding key EKG findings, and knowing when to escalate treatments, Dr. Chavez provides a comprehensive, algorithmic approach to these high-stakes scenarios.
Learn about the vital roles of medications like atropine and epinephrine, and the critical use of transcutaneous and transvenous pacing. This video is packed with practical insights to help you stay calm and effective when every second counts.
00:00 Introduction to Unstable Bradycardia
00:31 Initial Assessment and Key Indicators
02:30 Understanding Cardiac Output and EKG Analysis
04:55 Identifying Causes with the DIE Mnemonic
08:21 Treatment Approaches and Medications
10:56 Pacing and Advanced Interventions
11:50 Summary and Final Thoughts
To watch more videos from the ResusX conference, check out www.resusx.com/offers/bwjtxAHf
#UnstableBradycardia, #EmergencyMedicine, #CriticalCare, #CardiacEmergency, #BradycardiaManagement, #EKGInterpretation, #ResusEM6, #TheBrokenHeartConference, #Atropine, #Epinephrine, #TranscutaneousPacing, #TransvenousPacing, #Hyperkalemia, #CardiacOutput, #BetaBlockers, #CalciumChannelBlockers, #STEMI, #AVNode, #HeartBlock, #HypoxiaPrevention
Переглядів: 530

Відео

Stop Drowning Patients
Переглядів 4234 години тому
Let the comments rip! Day 4 of CritBits and I'm talking about the terrible practice of overloading septic shock patients with fluids. I highlight the need to switch to vasopressors like norepinephrine after an initial fluid bolus if hypotension persists. Excessive fluid administration can lead to organ ischemia and increased mortality, advocating for early vasopressor use to manage vasodilatory...
Don't Suck, Use Ultrasound
Переглядів 4467 годин тому
In this episode of CritBits, the importance of using ultrasound when treating patients in undifferentiated shock. Different types of shock require different treatments, contradicting the one-size-fits-all approach of administering 30 cc’s per kg to all patients. For instance, in cardiogenic shock, such an approach is not advisable. Ultrasound is crucial for assessing the heart's ventricles to d...
Beyond ATLS
Переглядів 5459 годин тому
Is airway management always your first step in trauma care? In this lecture from the ResusX: Golden Hour conference (see the link below for more lectures), Dr. Mohamed Hagahmed challenges conventional wisdom and explores when the airway may not be the top priority. He delves into the critical importance of preventing hypoxia, selecting the right induction agents, and mastering techniques like t...
Post-ROSC Care
Переглядів 1,1 тис.19 годин тому
What happens next after you get a pulse back in a cardiac arrest patient? In this lecture from the ResusX: ROSC conference (see the link below for more lectures), Dr. Haney Mallemat dives into the critical steps of post-ROSC care. He explains why the hardest work begins once the pulse returns, emphasizing the importance of stabilizing the patient to prevent re-arrest and ensuring neurologic int...
Massive Hemorrhage Protocol
Переглядів 1,4 тис.День тому
Ever wondered if you're truly maximizing your trauma resuscitation techniques? In this lecture from the ResusX: Golden Hour conference (see link below for more lectures), Dr. Chris Hicks talks about the Massive Hemorrhage Protocol (MHP), revealing why it's more than just about blood transfusion. He explores the critical shift towards supporting clotting and maintaining perfusion to vital organs...
Should I Stay or Should I Go?
Переглядів 1,2 тис.14 днів тому
In this eye-opening lecture from the ResusX: ROSC conference (see the link below for more lectures), Dr. Lindsey Ewing takes us on a deep dive into the high-stakes world of prehospital cardiac arrest management, revealing the secrets to maximizing patient survival with on-scene resuscitation. She explores the latest protocols highlighting higher quality CPR, timely rhythm checks, and the import...
Pigtail Chest Tubes How-To: Bigger Isn't Always Better (Demonstration)
Переглядів 75521 день тому
Dr. Jeremy Kaswer dives into the innovative use of pigtail chest tubes, proving that bigger isn't always better in trauma care in his lecture at ResusX: Golden Hour (see link below for more lectures). Learn how these smaller, less painful chest tubes are revolutionizing treatment for stable trauma patients, including those with hemothoracies and pneumothoraces. We walk through the entire proced...
Tox In A Code!
Переглядів 96621 день тому
In this lecture from ResusX: ROSC conference (see link below for more lectures), Dr. Matt Salzman dives into the critical role of toxicology in emergency medicine, especially during cardiac arrest scenarios. He breaks down the essentials of high-dose insulin therapy, highlighting its life-saving potential in beta-blocker and calcium channel blocker overdoses and the importance of early interven...
"By the way...I'm pregnant" - Two Patients in One Trauma Bay
Переглядів 64328 днів тому
Dr. Zaf Qasim tackles the complexities and critical considerations when managing trauma in pregnant patients in his lecture at ResusX: Golden Hour (see link below for more lectures). He emphasizes the importance of understanding normal pregnancy physiology to identify abnormalities, highlighting key changes in cardiovascular, respiratory, hematological, renal, and gastrointestinal systems. Dr. ...
Vent Alarms: Useful Not Annoying
Переглядів 1,2 тис.Місяць тому
Dr. Sara Crager demystifies ventilator alarms, explaining how they serve as critical indicators rather than nuisances from her ResusX: ReVolved lecture (see link below for more lectures). She emphasizes that understanding ventilator alarms can provide invaluable insights into a patient's pulmonary physiology. Dr. Crager breaks down the alarms into two main types: Low Tidal Volume and High Peak ...
Letting Your Patients Exhale
Переглядів 542Місяць тому
Dr. Steven Haywood emphasizes the critical importance of ensuring patients can properly exhale when using non-invasive ventilation (NIV) systems in this lecture from ResusX:Reset (see link below for more lectures). He explains that modern NIV setups often have a single limb circuit, necessitating an exhalation port to prevent mechanical and physiological dead space, which could otherwise lead t...
Lytics in the Sick PE Patient
Переглядів 1,4 тис.Місяць тому
Lytics in the Sick PE Patient
Critical Care Lounge: Steroids in Critical Care
Переглядів 633Місяць тому
Critical Care Lounge: Steroids in Critical Care
The 6P's of PreOx
Переглядів 1,4 тис.Місяць тому
The 6P's of PreOx
Anti-Dysrhythmics in the ICU
Переглядів 1,6 тис.Місяць тому
Anti-Dysrhythmics in the ICU
Femoral Doppler in Arrest
Переглядів 1,2 тис.Місяць тому
Femoral Doppler in Arrest
Norepinephrine: How High Can You Go?
Переглядів 1,3 тис.Місяць тому
Norepinephrine: How High Can You Go?
Coffee w/ Crit: Common Ground
Переглядів 1,3 тис.Місяць тому
Coffee w/ Crit: Common Ground
Mental Models for Resuscitation Expertise
Переглядів 1,1 тис.2 місяці тому
Mental Models for Resuscitation Expertise
Nursuscitation
Переглядів 9402 місяці тому
Nursuscitation
The Resuscitationist's Mindset
Переглядів 1,4 тис.2 місяці тому
The Resuscitationist's Mindset
Intubating The Obese Patient
Переглядів 1,6 тис.2 місяці тому
Intubating The Obese Patient
Bicarb in DKA
Переглядів 1,8 тис.2 місяці тому
Bicarb in DKA
CriticalCare Lounge: Pneumothorax
Переглядів 1,1 тис.2 місяці тому
CriticalCare Lounge: Pneumothorax
CAPE COD Trial
Переглядів 7792 місяці тому
CAPE COD Trial
What's the Patient's Status (Epilepticus)?
Переглядів 8592 місяці тому
What's the Patient's Status (Epilepticus)?
The Low-Flow LVAD
Переглядів 5293 місяці тому
The Low-Flow LVAD
How to Depressure-Eyes
Переглядів 6323 місяці тому
How to Depressure-Eyes
Life-Threatening Asthma
Переглядів 2 тис.3 місяці тому
Life-Threatening Asthma

КОМЕНТАРІ

  • @boudibla4011
    @boudibla4011 8 годин тому

    shout out to everyone that shouts out themselves.

    • @CriticalCareNow
      @CriticalCareNow Годину тому

      Shout out to you for that profound statement

  • @rumit9946
    @rumit9946 День тому

    great summary , thanks !!

  • @RishabhB
    @RishabhB День тому

    Is IVC collapsibility a good idea in determining whether the patient requires more fluids?

  • @eovc61
    @eovc61 День тому

    Excellent and thank you. Totally agree, especially with a MAP of less than 60.

  • @matheusferrari73
    @matheusferrari73 День тому

    Amazing

  • @mastilley3837
    @mastilley3837 2 дні тому

    Bs How can you say that All you are doing is pushing your agenda not good medicine

    • @CriticalCareNow
      @CriticalCareNow День тому

      I go with the data. You go with…..your opinions? Thanks for the comment though

    • @mastilley3837
      @mastilley3837 День тому

      @@CriticalCareNowit’s not opinion There is no good RCT to support most of what you say Again you are a blow hard who is trying to be funny and cool and push your agenda EM is a dead specialty

  • @medschoolvisual6954
    @medschoolvisual6954 2 дні тому

    MAP=COxTPRxBV, and ❤CO=HTxSV

  • @minutemanmedic4143
    @minutemanmedic4143 3 дні тому

    Emergency medicine physicians have become the “ultrasound bros” of medicine and it’s probably going to end up being one of the best developments EM has made.

  • @randys766
    @randys766 3 дні тому

    Beard Haney, Cold, wet, warm, dry, history, CVP, JVD, white count, fever, CXR, EKG, auscultation… Seeing is believing (ultrasound), and MI can have cytokine release that muddies the picture; however we can agree that there are usually some clues, and we should not throw away the skills that build our intuition. Wanna rain on my high-horse parade?? throw in the septic endocarditis patient with wide open MR! Now without US, you are sunk!

    • @CriticalCareNow
      @CriticalCareNow 3 дні тому

      Totally agree. Ultrasound is an augmentation of the physical exam

  • @daniellewestenmeyer8444
    @daniellewestenmeyer8444 4 дні тому

    Thank you! Love your content so much!

  • @zakalobi80
    @zakalobi80 5 днів тому

    Great talk. Thanks. I want to ask about the whole blood transfusion, which is a common practice in some areas. Can we utilise whole blood in massive transfusions?

  • @user-jz3iy6sr9g
    @user-jz3iy6sr9g 6 днів тому

    What king of magnesium? How dosed, by weight? I am female, 5’6”, 110 lbs. is there a difference in dosing men v women? Specifics please

  • @benben90b
    @benben90b 7 днів тому

    thank you

  • @susanv6554
    @susanv6554 8 днів тому

    I work in a 28 bed ICU and we do NOT have an intensivist. Whichever attending/hospitalist that shows up for the code.... leaves pretty quick after the code. These videos are so helpful, because even if I can't get/or keep a doctor nearby.... they give me the knowledge to know what to look out for and ask for post arrest. Rumor has it we'll be getting intensivist near the end of the year. It's going to be mind- blowing to have physicians available.... and actually making some decisions. And hopefully improving our outcomes, as precious time won't be lost as nurses spend precious time calling multiple doctors.... begging for ideas. Thank you for all that you do!

    • @CriticalCareNow
      @CriticalCareNow 7 днів тому

      Thank you for this. ❤️

    • @thebearded_guardian3671
      @thebearded_guardian3671 7 днів тому

      No NP or PA? Seems a bit dangerous aye! I pray yall get an intensivist soon!!!

    • @susanv6554
      @susanv6554 7 днів тому

      ​@@thebearded_guardian3671 Nope, just us nurses. Attending and consultations make a round, but they don't hang around for longer than they have to. A lot don't even bother to talk to us....a few do.

    • @thebearded_guardian3671
      @thebearded_guardian3671 6 днів тому

      @@susanv6554that’s horrible

    • @LoLwithAlol
      @LoLwithAlol 4 дні тому

      thats outright dangerous

  • @user-tz8yf4te2z
    @user-tz8yf4te2z 8 днів тому

    Amazing infp

  • @abdelbarifahej2775
    @abdelbarifahej2775 8 днів тому

    Thank you so much

  • @hmmthatsinteresting2693
    @hmmthatsinteresting2693 9 днів тому

    This is great. Thank you ☺️

  • @davidpecora7750
    @davidpecora7750 10 днів тому

    Great stuff. Thanks!

  • @michaelcole7215
    @michaelcole7215 11 днів тому

    as a hospital-based Intensivist, videos like this are an excellent way for me to get an alternative lens on how EMS and the ED are looking at resuscitative strategies. It informs my own practice even if I don't make substantive changes to my own resuscitations. Excellent video! (makes me think!)

    • @CriticalCareNow
      @CriticalCareNow 9 днів тому

      Thanks. You should check out our live conference in September / Philly.

  • @mohsinrasheed7811
    @mohsinrasheed7811 11 днів тому

    Hi Any possibility of online learning?

  • @marksmadhousemetaphysicalm2938
    @marksmadhousemetaphysicalm2938 13 днів тому

    What are your thoughts of paramedics doing eCPR in the field? I mean alfresco?

  • @guerrita6878
    @guerrita6878 15 днів тому

    Wow today in a code being run by an anesthesiologist and 2 CAAs, RT wanted us to take the intubated pt off the vent and bag 🤔

  • @andrealacarbonara7129
    @andrealacarbonara7129 21 день тому

    Please could you post a link ti improve knowledge about high-dose insulin therapy?

  • @andrealacarbonara7129
    @andrealacarbonara7129 21 день тому

    Funny buddies

  • @drayush2
    @drayush2 21 день тому

    You can utilise SAPB also to relieve pain during and after procedure

  • @drayush2
    @drayush2 21 день тому

    Atleast one inch to do finger sweep otherwise you ll struggle with finger

  • @ManjitKaur-gr6jj
    @ManjitKaur-gr6jj 21 день тому

    I have seen surgeons make bigger openings with the regular chest tubes - is this necessary?

  • @rustynail2310
    @rustynail2310 21 день тому

    If shock is VASOCONSTRICCIÓN, why then VASOPRESOR????

  • @lawschoolpro
    @lawschoolpro 22 дні тому

    Phenobarbitol doesn’t even touch aws like Ativan or Xanax.

  • @Baiji-xu8jc
    @Baiji-xu8jc 22 дні тому

    Pulmonary embolism

  • @elioquendo9400
    @elioquendo9400 23 дні тому

    How can a fluid filled aveoli collapse and cause a type 1 failure? It would have to be outside the aveoli to collapse it, wouldn't it?

  • @donatasset3089
    @donatasset3089 24 дні тому

    yea, better buy some stuff from pharmacy with hundred of side-effects, just don't use baking soda😂😂😂

  • @kubilaytimur8594
    @kubilaytimur8594 25 днів тому

    While we have ultrasound available, wouldn't it be more accurate if we look at the center and evaluate the contraction of the heart instead of looking at the vessels?

  • @thepalettewhispererasmr1227
    @thepalettewhispererasmr1227 25 днів тому

    Anything Amal says is gold... put my phone constantly wants to change his name to anal...

  • @brentlukacs3194
    @brentlukacs3194 26 днів тому

    This was great. Thank you!!!

  • @kubilaytimur8594
    @kubilaytimur8594 26 днів тому

    overreacting, annoying me :/

  • @patriciasimpson8737
    @patriciasimpson8737 26 днів тому

    I think she was chocking on the ventilator because she had pneumonia the week before she have a heart attack.

  • @patriciasimpson8737
    @patriciasimpson8737 26 днів тому

    Hi I have a question my mother passed away 2 weeks ago. She suffer cardiac arrest 4 time . She was placed on a ventilator 2 twice. They put a pacemaker and stent but nothing work.

  • @ManjitKaur-gr6jj
    @ManjitKaur-gr6jj 26 днів тому

    Great teacher 🙏🙏🙏

  • @gurvicmukanye5774
    @gurvicmukanye5774 27 днів тому

    this was simple, straight, and very efficient! thank you

  • @zakalobi80
    @zakalobi80 28 днів тому

    Impressive talk. Thanks

  • @shoreshidoshi
    @shoreshidoshi 28 днів тому

    Really well done ❤

    • @CriticalCareNow
      @CriticalCareNow 27 днів тому

      Thanks. The whole conference was incredible

  • @amaranathl9864
    @amaranathl9864 Місяць тому

    amazing explanatory skill of communication .thanking you

  • @drdannegoita
    @drdannegoita Місяць тому

    Now , the ventilatorul is my best ER friend. 😉

  • @eduardodiaz9354
    @eduardodiaz9354 Місяць тому

    22-30 mcg/kg/min I don’t think that’s even possible the highest concentration I’ve used is 16mg in 250 ml unless you mix a higher dose. The max at my hospital is 3mcg/kg/min

  • @robertolarios7561
    @robertolarios7561 Місяць тому

    Dr Sara always give great and very useful conferences, many thanks.

  • @alexsuyun9716
    @alexsuyun9716 Місяць тому

    I think a solution to this problem is creating new fellowship paths from EM. I.e if you have a pt with GI bleed that needs to be scoped at night, why do you need to wait for a GI doc to get down there? Why cant there be a GI scope fellowship for EM trained docs? Then we could pivot to do routine colonoscopies if we are afraid of burnout.