Afleveringen
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In this episode, we explore the RENOVATE study, comparing high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV or BIPAP) for acute respiratory failure. Discover the pros, cons, and practical takeaways for using HFNC in the ICU and ED.
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We welcome back Nicole Cook, APRN and CNS to talk all about sepsis... and Nicole shares a personal story about sepsis we won't soon forget.
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Zijn er afleveringen die ontbreken?
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Allan and Rob continue the conversation with Nicole Cook about neurotrauma. If you haven't listened to episode 26, part one of this conversation, then we suggest you go back to do so. However, we wouldn't recommend listening to us anyway.
Nicole's paper on Co2 - https://www.injuryjournal.com/article/S0020-1383(21)00624-0/fulltext -
We are proud to be project managers for (as far as we know) the only international, free, open source nursing course with the sole intention in fighting COVID-19.
covid19.epicclearning.ca
Authors from Canada, USA, United Kingdom, Italy, Belgium, New Zealand and Australia have volunteered to help support nurses caring for patients with COVID-19.
We recorded a podcast this week to give you more background if you'd like to hear.
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The CDC recommendation for homemade masks has lit a firestorm among health care providers. In this episode, we give our take on the recommendation. We also break down some interesting data on disease transmission.
AS ALWAYS, READ THE PAPERS AND COME TO YOUR OWN CONCLUSION.
ReferencesCDC. Strategies for Optimizing the Supply of Facemasks. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html
Doremalen, N et al. NJEM. https://www.nejm.org/doi/full/10.1056/NEJMc2004973
Ong et al. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2762692
Pyankov. Journal of Aerosol Science. https://www.sciencedirect.com/science/article/pii/S0021850217302239?via=ihub
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Sara, ICU RN is on the show to share her firsthand experience battling severe COVID-19. She shares what she has learned, tips to get you prepared, and touches on the human side of caring for the sick COVID-19 patients.
Resources
ARDSnet - http://www.ardsnet.org/
University Washington Medicine - https://covid-19.uwmedicine.org/Pages/default.aspx
Nicole Kupchik, CNS - https://www.instagram.com/nicolekupchik/?hl=en -
In our COVID-19 Critical Care series we are hitting you with the fundamentals of critical care that you may need when caring for COVID-19 patients.
Keenan, S. et.al. (2011). Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. Canadian Medical Association Journal. PMID: 21324867Nee, P. et.al. (2010). Critical care in the emergency department: acute respiratory failure. Emergency Medicine Journal. PMID: 21112972 Caples SM, Gay PC. Noninvasive positive pressure ventilation in the intensive care unit: a concise review. Crit Care Med. 2005;33(11):2651–2658.
In this episode we cover non-invasive positive pressure ventilation and continuous positive airway pressure ventilation.
References -
This podcast was recorded on March 13, 2020. The content of the podcast may change as new information becomes available. Always check with your local resources and sources with credible references.
One of the places resuscitation begins is at the front door. In this episode we provide practical tips for nursing care for patients with suspected or confirmed COVID-19.... in fact, this information could be generalized to all patients with undifferentiated dyspnea.
The Internet Book of Critical Care is a living resource for COVID-19.
REBEL EM has an excellent look at COVID-19 -
We are pleased to have the trailblazer Tammy Lowe and THE Korbin Haycock on the show to share their amazing Nurse Point of Care Ultrasound program, one of the only programs in the world (to our knowledge - please correct us if we're wrong... we'd love to learn more!).
Their Nurse Point of Care Ultrasound program was published in the Annals of Emergency Medicine in 2017. The link to the paper is HERE.
Tammy is a boss level Registered Nurse and the Clinical Administrator for Critical Care at a large hospital in California. Find Tammy on Twitter HERE @TammyLowe357
Korbin is an emergency physician and the definition of a resuscitationist. Find him on Twitter HERE @KHaycock2 -
Allan and Rob have the privilege of having a chat with Alin Gragossian about the days before her illness, heart transplant, and return to her work as an emergency medicine resident.
Follow Alin!
Website - https://www.achangeofhe.art/
Twitter: @ag_em33
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Do ED ICUs save lives? Probably.
The paper in question is by Gunnerson et al and can be found here.
Scott Weingart's work on ED ICUs can be found here. -
Allan and Rob talk about learning in the clinical environment.
The relationship mattersIntentionality in clinical conversationsWhat's the yield on your clinical questions?
Main topics -Some interesting papers -
Eva, Kevin & Regehr, Glenn. (2008). “I'll never play professional football” and other fallacies of self-assessment. The Journal of continuing education in the health professions. 28. 14-9. 10.1002/chp.150. Eva, Kevin & Regehr Glenn. (2007). Knowing when to look it up: a new conception of self-assessment ability. Academic Medicine : Journal of the Association of American Medical Colleges. 2007 Oct;82(10 Suppl):S81-4. DOI: 10.1097/acm.0b013e31813e6755Debriefing with Good Judgment: Combining Rigorous Feedback with Genuine Inquiry
Rudolph, Jenny W. et al. Anesthesiology Clinics, Volume 25, Issue 2, 361 - 376
The show page is found here. -
Nyssa from The Q Word Podcast is on the show to talk about the one thing we should be practicing the most: Resuscitation Langauge, coined Resuscitese.
https://www.jpeds.com/article/S0022-3476(14)00878-6/fulltexthttps://emcrit.org/wp-content/uploads/2016/06/Improving-Verbal-Communication-in-Critical-Care.pdfhttps://emcrit.org/emcrit/learning-speak-resuscitese/https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201412-552PS (particularly the sections titled “Ask the Other Clinicians Present for Input,” “Stop Resuscitation Efforts” and “Explain What Has Happened to the Family.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278143/
References -
Allan and Rob's final ResusX Series Podcast where they talk about the Zero Point Survey and its place in the resus room with our friends EM Centered (emcentered.com) and Salim Rezaie (rebelem.com).
Cliff Ried's Paper - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166036/EMCRIT's post with Cliff Ried - https://emcrit.org/emcrit/emcrit-wee-zero-point-survey-video-by-cliff-reid/St. Emlyn's blog post - https://www.stemlynsblog.org/jc-the-zero-point-survey-optimising-resuscitation-teams-in-the-ed-st-emlyns/
Zero Point Survey further reading- -
We had the opportunity to present The Nurse Led Code and facilitate a Code Choreography workshop to the attendees at ResusX. Needless to say, it was a humbling to learn alongside the curious, bad ass physicians that attended.
We even had the chance to talk to Scott Weingart about The Nurse Led Code which was pretty cool, given that his podcast was the first place we heard of it.
ReferencesThe fun piece of The Nurse Led Code is that it hasn’t had direct, published data. So, if you’re a nurse looking for a research project, I recommend you look at this setup!
Click here for our references.
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Allan and Rob have the privilege of sitting down with Salim Rezaie of RebelEM to talk about cervical spine collars and backboard in the ED. RebelEM has has already extensively covered the evidence on collars and backboards. You can find their blog posts and links below.
1. Spinal immobilization in trauma patients
2. Cervical spine evaluation and clearance in the intoxicated patient
3. Stiell et al. (2018) - A Multicenter Program to Implement the Canadian C-Spine Rule by Emergency Department Triage Nurses
4. Skeptics Guide to Emergency Medicine - Ep 232 - An overview and literature evaluation of cervical spine collars and an appraisal of the above paper
5. Dr. Ken Milne and Alison Armstrong filmed a news clip on the 2018 Stiell et al. paper for us at NENA 2019. -
Allan and Rob travelled to Philadelphia for the ResusX and MedED Evolved Conferences. Philly cheese steaks were consumed, learning occurred, and podcasts were made.
The next few episodes will be a mini-series recorded with some new friends from ResusX and MedED Evolved! - Laat meer zien
