Anatomy of a Resuscitation

EM Basic

EM Basic LLC

Residency, Student, Medicine, Er, Em, Intern, Health & Fitness, Medical, Education, Emergency

4.6 • 665 Ratings

🗓️ 7 August 2013

⏱️ 19 minutes

🔗️ Recording | iTunes | RSS

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Summary

This episode is something unlike anything I have ever done with EM Basic. I had a case recently of a super sick patient who required a big resuscitation. Fortunately, the patient did great and was gracious enough to give me her permission to share her case so that others can learn. In this episode, we'll go over what happened with this patient step by step and I'll review some valuable teaching points on how to get things done in the resuscitation bay and how to think about treating critically ill patients.

Transcript

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0:00.0	This is Steve Carroll, and you're listening to the Amb Basic podcast. Today we're going to be doing
0:05.7	something completely different. This episode is what I'm going to call anatomy of resuscitation.
0:11.6	What I will do is walk you through a case that I had recently of a really sick patient and explain
0:17.3	some of my thought processes while I was resuscitating the patient.
0:27.2	Before we go any further, let me explain that I got the patient's explicit permission to talk about her case for this podcast.
0:32.7	She was very eager for others to learn about what she went through and truly wants to pay it forward.
0:40.7	Of course, I won't disclose any of her identifying details, but I just want to make it clear that the patient gave me her permission to talk about her case.
0:44.2	Also, I want to say that I have no expert in resuscitation.
0:49.9	There are a few points where I could have done better, and I'll talk about those areas so we can all learn from it.
0:55.2	In this podcast, we'll talk about some pretty advanced topics in resuscitation, but I think anyone in EM can benefit from thinking through this case and seeing how it was run. With all that
1:01.1	being said, let's get started. As always, this podcast doesn't represent the foods, opinions, department
1:05.4	defense, the U.S. Army, or the Fort Hood Post Command. So here's the case. I was working at a
1:10.3	community hospital without any
1:11.9	resident coverage. Out of nowhere, one of the nurses said, we need some help in bed three. Whenever you
1:18.2	hear any needy nurse say this, you need to run to the bedside because there's probably a really sick
1:22.4	patient. So the patient is a 32-year-old female who has to be lifted onto the ED stretcher.
1:29.2	The only information I had was that she was altered and hypotensive at triage and has
1:34.2	had two weeks worth of intermittent vaginal bleeding.
1:37.6	Her vital signs are a BP of 70 over 40, heart rate in the 120s, and a pulse
1:42.6	of 100% on room air. As far as her exam, when I go to
1:46.9	talk with the patient, she is definitely altered and ill-appearing. She can answer in one or two
1:52.0	words sentences, but she immediately dressed off when you stop talking to her. She's protecting
	...

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