Ep 131 PEA Arrest, PseudoPEA and PREM – With Simard and Weingart

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 22 October 2019

⏱️ 55 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Rob Simard of POCUS Cases fame and Scott Weingart go beyond ACLS and guide you through the complex world of PEA. We discuss that the palpation technique is poor at determining whether or not a patient has a pulse, that the POCUS pulse is more accurate and as rapid compared to the palpation technique at determining whether or not a patient has a pulse, the difference between true PEA arrest, PseudoPEA and PREM, why epinephrine may be harmful in PEA, Weingart's chain of survival approach from PEA arrest to ROSC, four tools to help differentiate true PEA arrest from PseudoPEA, how to prevent long pauses in chest compressions using POCUS, EM Cases PEA arrest and PseudoPEA suggested dynamic algorithm, vasopressor choices in PseudoPEA, whether the "QRS wide vs narrow width" approach to PEA arrest underlying cause is useful or not and much more...

Transcript

Click on a timestamp to play from that location

0:00.0	And now for something completely different.
0:04.6	We're going to start off with Dr. Rob Simard, the creator of Pocus Cases, the video series on
0:09.9	the EM cases website, who gave one of the best talks I've heard at the EM cases course, June
0:16.1	2019.
0:17.9	As you'll hear at a moment, he goes beyond ACLS by telling the story that turned him onto the power of Pocus for ACLS and then gives you his approach to P-EA arrest.
0:32.3	Now, because this is a controversial topic, I invited none other than Scott Weingart to then discuss his approach
0:39.1	to PEA arrest. And as you'll see, there's quite a bit of overlap, but a few nuanced
0:44.7	differences. By the end of this podcast, I hope that you'll settle on your own way to manage
0:50.2	PEA by taking the best parts of these approaches and integrating them into your local
0:54.8	practice.
0:56.2	Take it away, Rob.
0:58.3	My name's Rob Samard.
1:00.2	I'm one of the emergency physicians here at North York General as well as at Sunnybrook Hospital.
1:05.7	And I'm going to give you a talk on going beyond what ACLS teaches you, beyond the algorithm. And a little bit of
1:17.0	a disclaimer, a lot of what I'm going to talk about is controversial today. I can tell you that what
1:22.9	I'm going to talk to you about, where we go beyond ACLS, it's not evidence-based. We're starting to
1:31.0	build some evidence for what I'm going to talk about, but it's not going to be in the next
1:35.4	guidelines yet. We still have a lot of work to do regarding the evidence for it. So a lot of
1:42.2	people say, you know, like, hey, I've been a clinician for 20 years. I see that you guys are using point of care ultrasound. I don't feel it makes me any faster. In fact, when I take over for other patients, I see there's a million people in the department. It's because they use ultrasound, it slows them down. And I've never needed it for the last 20 years to help my patient care. I don't know why you guys use it. So people say, why do I use Pocus? Like I say that I'm a good clinician. Why do I need Pocus to help me out?
2:05.8	So let me tell you why. I'll bring it back to a case that really kind of opened my eyes a bit as to limitations that we have as clinicians. So Marz and I'm going to tell you the story of how he was
2:01.8	convinced of the power of Pocus in
2:19.6	A-CLS.
	...

Please login to see the full transcript.

Previous episode | Next episode

Disclaimer: The podcast and artwork embedded on this page are from Dr. Anton Helman, and are the property of its owner and not affiliated with or endorsed by Tapesearch.

Generated transcripts are the property of Dr. Anton Helman and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.