Tag Archives: resuscitation

ECPR by Vincent Pellegrino

On August 17th 2016, Associate Professor Vincent Pellegrino, Head of the ECMO service at The Alfred ICU, discussed ECPR during an in-house education session.

His discussion included:

  • the difficulties with ECPR definitions and selection criteria
  • Approaches to ECPR, ranging from cannulation techniques and types of cannula, to role cards and the importance of teamwork
  • Outcomes for ECPR and the evidence for the technique

Listen to the talk to find out more – the podcast is 37 minutes long.

THE VIDEO

THE SLIDES

For more on ECMO check out INTENSIVE and EDECMO.org.

The RAGE podcast is on  iTunes here and the RAGE podcast audio feed is available here.

Thanks again for listening to the RAGE!

Steve Bernard’s Resuscitation Update 2015

On November 11th 2015, Professor Steve Bernard (@AmbVicMedic), Medical Advisor to Ambulance Victoria, presented a smorgasbord of ‘Updates in Resuscitation‘ at The Alfred ICU junior medical staff teaching session.

He discussed:

  • Recent data from registries on in-hospital and out-of-hospital cardiac arrest (OHCA), particularly from Victoria, and the reasons why OHCA results may be improving
  • Options for treatment of refractory VT/VF, including the CHEER2 trial
  • The RINSE trial: is intra-arrest cooling with ice cold IV saline for OHCA a good thing?
  • Highlights from the recently released updated ILCOR guidelines, which will form the basis for the next ARC guideline update

Listen to the talk to find out more – the podcast is 47 minutes long.

For more talks by Steve Bernard, check out INTENSIVE.

The RAGE podcast is on  iTunes here and the RAGE podcast audio feed is available here.

Thanks again for listening to the RAGE!

Cutting Edge Intra-Arrest Care

The RAGE team owe a lot to Mr EMCrit Scott Weingart. Together with Rob Orman of ERCast, he was instrumental in helping us get the technical aspects of podcasting in order as we found our podcasting feet.

Here is Weingart in action at smaccGOLD. His talk on ‘Cutting Edge Intra-Arrest Care’ is unequivocally essential listening for anyone who follows the RAGE podcast.

It is controversial.

He calls for resuscitationists to go beyond ACLS and function on the bleeding edge of critical care.

Critics will argue that early adoption is intensely dangerous. I am sure that some of the things Scott talks about will prove to be false in the fullness of time (I just can’t see vasopressin-epi-steroids being validated by bigger multi-center trials, for instance).  Nevertheless, this is a masterful talk by a master resuscitationist.

If you resuscitate, you must listen to this talk!

This is the audio: (direct download mp3 here):

These are the slides:

This is the video:

The Art and Science of Fluid Responsiveness

Unavoidable delays mean you’ll have to wait a bit longer for RAGE Session 4… But it is in the works, we promise!

In the meantime check out this masterful smaccGOLD presentation by the RAGE team’s very own Haney Mallemat: ‘The Art and Science of Fluid Responsiveness’.

Here is the audio (download the mp3 directly here):

Here is the video:

Learn more about related topics via the LITFL CCC:

To listen to all the smaccGOLD talks as they are released subscribe to the SMACC podcast on iTunes.

RAGE Session One

You’d be forgiven for thinking it was never going to happen… but it has… the first RAGE Session is finally here!

RAGE Session One is 71 min 7 sec long and includes:

  • Introduction, including the RAGE team ‘meet and greet’ (starts 00:00 min)
  • ‘What’s bubbling up?’ (starts 05:40 min) — shout outs and interesting discoveries from the world of FOAM and elsewhere featuring CO2 retention in COPD, the LINC trial, intraosseous blood transfusion, Rory Spiegel’s EM Nerd, the ‘quick look’ CT in ‘semi-stable’ trauma patients and fallen cycling legend Martyn Ashton
  • the RAGE team discussing ‘The post-TTM era: homeopathic hypothermia or aggressive normothermia?’ (starts 25:20 min)
  • the RAGE team’s discussion on ‘Septic and hypotensive: what next?’ (starts 39:06 min)
  • ‘A blast from the past’ on critical care deity Peter Safar, presented by Haney Mallemat (starts 63.57 min)
  • ‘Wise Words’ featuring Descartes and Diderot, presented by Michelle Johnston (starts 67.58 min)

It’s early days and we expect to incrementally improve the format, presentation and audio quality with each episode. To make this happen, we need your feedback — leave comments on this post or contact us here (especially if you want to appear on the show, correct us or respond to an episode in audio format).

The RAGE podcast has been submitted to iTunes , but is not yet available there  and is available here. The RAGE podcast audio feed is available here.

Read on for the ‘show note’ links for RAGE Session One…

Intro

What’s bubbling up?

httpv://www.youtube.com/watch?v=HhabgvIIXik

The post-TTM era: homeopathic hypothermia or aggressive normothermia?

  • Nielsen N et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med Nov 17 2013 doi: 10.1056/NEJMoa1310519
  • Reports of therapeutic hypothermia’s death are greatly exaggerated (LITFL)
  • All in a lather over TTM (LITFL)
  • Post-arrest care: EMCrit interview with Stephen Bernard part 1 and  part 2
  • Dumas F, et al. Is hypothermia after cardiac arrest effective in both shockable and nonshockable patients?: insights from a large registry. Circulation. 2011 Mar 1;123(8):877-86. doi: 10.1161/CIRCULATIONAHA.110.987347. Epub 2011 Feb 14. PubMed PMID: 21321156. [Free Full Text]
  • Kim F et al. Effect of Prehospital Induction of Mild Hypothermia on Survival and Neurological Status Among Adults With Cardiac ArrestA Randomized Clinical Trial. JAMA Nov 17 2013  doi:10.1001/jama.2013.282173
  • Jacobs IG, Finn JC, Jelinek GA, Oxer HF, Thompson PL. Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial. Resuscitation. 2011 Sep;82(9):1138-43. doi: 10.1016/j.resuscitation.2011.06.029. Epub 2011 Jul 2. PubMed PMID: 21745533.
  • Nehme Z, Andrew E, Bernard SA, Smith K. Treatment of monitored out-of-hospital ventricular fibrillation and pulseless ventricular tachycardia utilising the precordial thump. Resuscitation. 2013 Dec;84(12):1691-6. doi: 10.1016/j.resuscitation.2013.08.011. Epub 2013 Aug 27. PubMed PMID: 23994203.

Septic and hypotensive: now what?

Blast from the Past

Thanks for listening to the RAGE!

Special thanks to Scott Weingart and Rob Orman for technical advice in making this happen — we will follow your advice more closely next time ;-)