Resus Tonight - Critical Care and Emergency Nursing

Resus Tonight - Critical Care and Emergency Nursing

We are two bros who are curious to learn how critical care & emergency nursing can be better. We translate research into everyday clinical practice, challenge the sacred cows of nursing and occasionally rant (sometimes at each other).... Show More

Episodes

September 7, 2020 31 min

This episode features two brilliant guests: Nick and Hussein. Nick is a husband and father. He also has cystic fibrosis and is a double lung transplant recipient. 

Hussein is an ICU and emerg doc with specialty in ECMO. His ECMO team helped bridge Nick to his transplant.

Listen to their experience!

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April 15, 2020 7 min

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.

References

CDC. Strategies for Optimizing the Supply of Facemasks. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html

Doremalen, N et al. NJE...

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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

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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 noninvasive continuous positive airway p...
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    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 w...

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    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 Re...

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    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

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    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. 10.1002/chp.150. 
  • Eva, Ke...
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    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/AnnalsATS.201412-552P...
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    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-cliff-reid/
  • St. Emlyn&...
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    October 17, 2019 17 min

    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 Code is that i...

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    October 8, 2019 2 min

    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!

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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 ...

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    September 23, 2019 13 min

    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 patient arrives so...
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    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 the perip...
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    September 4, 2019 11 min

    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. 

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    August 30, 2019 27 min

    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 as a marker of m...
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    This is part 2 of 2 of our interview with Landon and Monique from the NursEM Podcast.

    ---
    Twitter: @ResusTonight

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