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management diagnosis treatment covid19 failure hypoxia respiratory schema bilevel bipap cardiology chf clinical comparison differential emergency evaluation extracorporeal foamed heartfailure
Extracorporeal Membrane Oxygenation (ECMO) - Basics Mode of cardiopulmonary support used to treat pulmonary and/or cardiovascular failure
) - Basics Mode ... Lmin (100-150 mL/kg ... Assess perfusion (eg ... #Basics #management ... #pulmonary #criticalcare
Approach to Selecting Respiratory Support: -The role of noninvasive respiratory support is generally to reduce the patient's
Selecting Respiratory Support ... be made on the basis ... patient's diagnosis (e.g ... #Management #CriticalCare ... RespiratorySupport #Selection #Algorithm
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 General schema for respiratory support in patients with COVID-19 Low flow nasal cannula • Typically set at
for respiratory support ... volumes of ~6 cc/kg ... discussion With ECMO ... management #schema #criticalcare ... hypoxia #failure #algorithm
Mechanical Ventilation: The Basics In the most basic sense, ventilator modes are defined by their control variable
Volume: 6-8 cc/kg ... 88% Pressure Support ... with pressure to support ... Delivers pressure support ... Comparison #management #criticalcare
Proposed Respiratory Support Algorithm in COVID19 The ‘intubate early’ paradigm, where patients who “fail” low flow oxygen
Proposed Respiratory Support ... Algorithm in COVID19 ... low flow oxygen (e.g ... #respiratory #support ... management #schema #criticalcare
Shock - Diagnosis and Management Summary • Hypotension: SBP<90, SBP drop >40, MAP<65 (Normotension, HTN possible
telemetry, 12-Lead EKG ... Ensure adequate support ... elevated JVP, echo ... Management #Summary #criticalcare
Approach to Possible Hypertensive Emergency criteria required to diagnose hypertensive emergency (1) Severe hypertension - Usually a MAP
hypertension (e.g ... ultrasonography might support ... Emergency #Diagnosis #Algorithm ... #CriticalCare #
Preoperative Risk Evaluation Major Pre-Op Questions: 1. Does the patient have any modifiable risk factors that could be
Key Components: ... physical exam - Key components ... event, follow ACC algorithm ... indicated • EKG ... Obtain EKG if:
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
ECG is vital while ... even mechanical support ... Impella, LVAD, ECMO ... #differential #algorithm ... heartfailure #chf #criticalcare
Hypothermia - Protocol for ED CORE TEMP < 34º INITIAL THERAPY • Remove wet garments • Avoid rough
Lipase, CK • ECG ... Consider inotropic support ... Consider inotropic support ... : ECMO/CPB • Continue ... management #treatment #algorithm
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