Resus Tonight - Critical Care and Emergency Nursing
The Resus Tonight team is curious to learn how critical care & emergency nursing can be better. The team translates research into everyday clinical practice, challenge the sacred cows of nursing and occasionally rant.
Episodes
Introductions to Allan, Rob, and the Resus Tonight vehicle. We're most active on Twitter @ResusTonight.
The intubated, altered neuro patient waiting for an ICU bed in your ED can be daunting. Here we talk about the best ways to examine, trend, recognize, and communicate your findings to your team.
- Components to one method of neurological exam
- The pitfalls of the Glasgow Coma Scale
- Brain anatomy in ICP
Are you looking for pathology beyond a STEMI when ordering and interpreting a 12-lead EKG? In this episode we introduce you to other patterns you should look for, especially in the undifferentiated patient presenting with a suspicious story. We'll have you quoting Sgarbossa, Brugada, and AvR pathology in no time!
- Sgarbossa - https://litfl.com/sgarbossa-criteria-ecg-library/
- Brugada - https://litfl.com/brugada-syndr...
This is part 1 of 2 with our friends Landon and Monique from the NursEM podcast where we about common legal, regulatory, and advice for documentation.
- Does charting MD aware absolve you from responsibility?
- Does charting will continue to monitor actually mean anything to a nursing legal expert and a regulatory body?
- How is the regulatory college of nurses different than the legal system?
Find the NursEM podcast at http:///www...
This is part 2 of 2 of our interview with Landon and Monique from the NursEM Podcast.
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Twitter: @ResusTonight
If you aren't using waveform capnography where appropriate, you are not evaluating ventilation and gas exchange properly.
It is a highly reliable way to evaluate CPR effectiveness and return of spontaneous circulation
- It can also be used as a prognosticator for cardiac arrest
- Capnography is probably the single most useful tool for monitoring patient status during procedural sedation
- Waveform capnography can be used a...
In our experience, nurses get little to no education on cognitive bias in their bachelor's degree program. For a review of anchoring bias, click here.
Allan shares a clinical experience where he anchoring bias can affect patient care.
Alpha, beta, V1 and V2 receptor goodness is talked about in this episode. This episode also features Allan turning into The Rock.
- Inotropy means increased myocardial contractility
- Chronotropy means increased heart rate
- Vasopressor means squeezing of the blood vessels
- Scott Weingart (reference below) coins a term Inopressor, where some drugs cause all of the above – one such example is epinephrine
- Alpha 1 receptors are found in ...
Rob recounts the story of his first traumatic cardiac arrest as a paramedic.
- CPR doesn't make sense in a traumatic arrest where hemorrhagic and obstructive shock are the suspected etiology
- A 'three hole punch' are bilateral finger thoracostomies and a pericardialcentesis is one way to decompress the chest in blunt traumatic cardiac arrest
- The nurse's role is to ensure a shared mental model once the ...
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 Mul...
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!
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.
References
The fun piece of The Nurse Led...
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).
Zero Point Survey further reading-
- 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-clif...
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.
References
- https://www.jpeds.com/article/S0022-3476(14)00878-6/fulltext
- https://emcrit.org/wp-content/uploads/2016/06/Improving-Verbal-Communication-in-Critical-Care.pdf
- https://emcrit.org/emcrit/learning-speak-resuscitese/
- https://www.atsjournals.org/doi/pdf/10.1513/AnnalsA...
Allan and Rob talk about learning in the clinical environment.
Main topics -
- The relationship matters
- Intentionality in clinical conversations
- What's the yield on your clinical questions?
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....
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 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
Instagram: @a_change_of_heart_blog
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.
Ta...
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 ...
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.
In this episode we cover non-invasive positive pressure ventilation and continuous positive airway pressure ventilation.
References
- Keenan, S. et.al. (2011). Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and n...
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