(Last Updated On: May 6, 2017)

ACLS/Sick vs Not Sick with Dr. Jess Barber:

  1. Good, consistent, uninterrupted compressions are essential in any code
  2. Compressions, defibrillation, running a systematic code are more important than intubation
  3. In tachycardia, stable vs unstable should be your first question
  4. Treat every patient you are coding like you would treat a loved one

Drug Choices for Sedation with Erin Gavin, PharmD:

  1. Use an analgesia-first approach to sedation
  2. Use Benzodiazapine-based regimens sparingly due to risk of delirium
  3. Dexmedetomidine is NOT appropriate sedation for paralyzed patients
  4. Know your dosing units

Reading ABGs with Dr. Michael Joo:

  1. Determine acidosis or alkalosis. As a general rule pH will be abnormal, but always refer to your HCO3 and ABG values as mixed disorders may have normal pH
  2. If pH and PaCO2 change in the same direction it is likely metabolic.  If change is in the opposite direction likely respiratory.  This rule can change when there is a MIXED acid/base disturbance, but always a good starting point.  Set the presumed primary process based on the change of pH and PaCO2 and if a concordant mixed process exists, determine this when you perform calculations and find compensation is not appropriate

The Critically Ill Obese Patient with Dr. David Snow:

  1. Always plan for the airway to be difficult…
  2. These patients will desaturate quickly (think about the FRC/VC/TLC decreases with BMI increase)
  3. Know how to perform an awake intubation
  4. Know how to ‘weight’ dose the big 4 meds:
    • Total Body Weight: Succ & Etomidate
    • Ideal Body Weight: Roc & Ketamine
  5. Positioning is key for intubation – ramp them up!
  6. Tidal Volume: 6ml/kg using Ideal Body Weight
  7. PEEP – start at 10-15 cm H2O (think again about the FRC decrease)
  8. After intubation, place them in Reverse Trendelenburg
  9. Avoid Trendelenburg at all times during the patients care (given the cardiovascular changes with obesity)
  10. Using a spinal needle for central-line placement (if too much subq space, using an 18 gauge spinal needle as the introducer)

Clinical Controversy, Epinephrine in Cardiac Arrest, With Drs. Maggie Sheehy & Benazir Chhotani:

  1. For further information about current research for/against Epinephrine in cardiac arrest, this is a great website which present information in a more objective manner: http://www2.warwick.ac.uk/fac/med/research/hscience/ctu/trials/critical/paramedic2/evidence/
  2. For further information on the Paramedic2 trial which Dr. Markul mentioned, please see the following: http://www2.warwick.ac.uk/fac/med/research/hscience/ctu/trials/critical/paramedic2/