Zack Shinar Teaches Basic Resuscitation in Cameroon, Africa!

For the next three weeks Zack is in Camaroon, Africa!  Obviously reviewing just the basics of resuscitation and triage, hopefully Zack will return (at all!) with some insightful thoughts on how far we've come in First World medicine.  When he gets back, I'll have Zack post a note on his experiences and what WE can learn from their World.

Here are some initial pics of Zack teaching the locals:

 

 

Meducation in Africa

Meducation in Africa

Meducation in Africa!

Meducation in Africa!

And of course they need a “Crash/Resuscitation Cart” at the Medical Clinic!!:

photo

 

Google Glass during ECPR!?!?

I just received Google Glass as part of their “Explorer program.”  Initial impression is that this may be a very interesting way to dip my toes in the idea of a “heads up display” during resuscitations.  Going forward I will be video-recording ECPR cases using both Glass and my Go-Pro…for educational purposes.  As many of you know I've recorded several ECPR cases and some of those videos are already on the website.Glass doctor

In addition I've loaded several resources into the device for instant access: weight-based range of cannula sizes, ideal flow rates, etc. All can be pulled up hands free.

Ideally I'll be able to get Point-of-view video for upload.

…more to come.

~Joe

The ED ECMO boys are speaking at Essentials of Emergency Medicine in San Francisco!

Zack, Joe and Scott will be doing a whole morning this year at the 2014 Essentials of Emergency Medicine in San Francisco November 7-10 at the Marriott Marquis. And Weingart is mediating!  We are doing some really cool stuff on “EXTREME RESUSCITATION!”  Take a look at the itinerary below:

 

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This is THE premier conference for Emergency Medicine and Critical Care specialists.  We have no disclosures regarding this conference except to say that it TOTALLY ROCKS!

Register for this conference now!

See you there!

NEW! Mobile-optimized version of www.edecmo.org

Weingart designed the NEW mobile version of our site!  Navigate to the site via any mobile device (iPhone, Android, etc) and check it out! There's even an audio player embedded so podcast episodes can be streamed directly to your device.

 

Better yet, use any scanning app and scan the www.edecmo.org custom barcode, using your mobile device, and you'll be taken right to the mobile-optimized site: QR

 

 

Don't have a scanner app on your device?  I recommend the following FREE scanning apps:

iphone/iPad: QR reader, QR Code Scanner and Reader, or Quick Scan

Android: QR Reader or QR Code Reader

The Resuscitation Cart

Zack and I have talked a lot about the “Resuscitation Cart”.  Here is our Resuscitation Cart 2.0 which was just overhauled.  This cart has almost everything we use during resuscitations in our ED and gets brought to the bedside for every code or crashing patient.

For non-ECPR cases, the only additional equipment needed are your crash cart, ultrasound machine, RSI equipment, and (optional) your mechanical chest compression device.  EVERYTHING else is on this cart including IV ACCESS, IO, Rescue Airway supplies, etc.

For ECPR cases we use the above items in addition to the ECMO cart (contents checklist previously posted) and the ECMO machine.

Resuscitation Cart

Resuscitation Cart

Drawer 1

Drawer 2

Drawer 3

Drawer 4

Drawer 5

Side Bins

 

 

 

 

The Resuscitation Cart

The Resuscitation CartResuscitation Cart Inventory April 2014

 

***special thanks to Melody Shedlosky RN for assistance with establishing the SMH resuscitation cart.

 

EDECMO Episode 6 – On Life & Death with Peter Rosen

Today I sat down with Dr. Peter Rosen to talk about the topic of life and death.

Peter is a close friend and one my mentors throughout my training and career. I trained under Peter as a resident at UCSD and I whenever Peter is in town I try to meet up with him to talk about anything BUT emergency medicine!  He usually tries to goat me into a tennis match but I've been beat up too many times to take the thrashing anymore!

Today I convinced Peter to go on-the-record with me and talk a little bit on the topic of life and death, since the topic is so important to what we are doing with ECPR.  Peter has spent decades watching gadgets, toys, and technology come and go – and carries a very understandable skepticism toward any process that artificially prolongs life.  I'm not sure I convinced him during this session but my career goal will be to show him that ECPR works in the right patient population.

Hearing Peter talk is always fascinating and I hope to have him on regularly on the podcast.

Enjoy the Episode:

The www.edecmo.org QR barcode

use any QR scanner app on your iPhone or Android to scan the www.edecmo.org QR barcode.

save the image and send to your friends and colleagues to share the goodness…

QR

The Sharp Memorial Hospital ECMO Equipment Checklists

Our ECMO cart checklist and femoral artery cutdown checklist were added to the “ECLS EQUIPMENT” section of the edecmo.org website. Check them out!

Episode 5 – Cognitive Task Analysis of Stages I and II of Extracorporeal CPR

Joe and I discuss ECPR cannulae placement from a cognitive task analysis (sort of) perspective. Beware: agonizing detail follows.

I believe this episode may help you even if you never do ECMO, as it is directly applicable to large central line placement as well.

Hot off the press: Chest Compressions are Probably Safe for LVAD patients

Shinar/Bellezzo paper:

Our most recent paper, Chest compressions may be safe in arresting patients with left ventricular assist devices (LVADs), has just been accepted for publication in the journal Resuscitation.  This paper is the largest known review of patients with LVAD's who arrest.  Our best evidence suggests that it is safe to do chest compressions in LVAD patients. Chest compressions don't appear to dislodge the VAD. Besides, the patient is going to die anyway!

By the way, the most common cause of arrest in these patients is ACCIDENTAL DISCONNECTION of both battery supplies! So if you get the call from the radio nurse with an LVAD patient that has arrested: 1. start chest compressions…it appears to be safe and 2. find a power supply or spare batteries!

Here is the abstract:

 

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