WHERE in the World is Zack Shinar??!!

Cameroon, Africa

Cameroon, Africa

Zack is in Cameroon, Africa for 3 weeks visiting his amazing brother, who is a missionary over there.  He has very little access to the outside World and is overwhelmed with the dichotomy of our “world” of medicine and what he is experiencing over there.  Here is yesterday's email:

“Seriously rough day today.  I helped take a post-op c-section with sepsis back to or.  She died later today.  Under resuscitated.  I think I could have done better.  Open skull fx mca is looking awful.  I can see about 30 percent of his r brain missing from plain exam.  We washed him out today.  Plan to use Dr. xxxxx's fat transplant idea when cleaner.  Still not sure exactly best plan for him.  I put a pin in a kid with a mangled foot.  Tendon repair is not really an option.  Infant died of pneumonia.  Malaria everywhere.  Coartem for all!  Certainly humbles me to pray, makes me question the massive discrepancies in the world, and yet makes me value their simplicity of life so lacking from my current state.” ~Zack

 

 

 

 

Today, Zack sent a photo of their “Difficult Airway Cart”. This stuff really makes you appreciate what we have!

Airway

The “Airway Cart”

 

 

 

 

 

Here are some more shots Shinar just sent:

Cameroon OR

Cameroon OR

Shinar on Cameroon Radio Show

Shinar on Cameroon Radio Show

Cameroon EMS!

Cameroon EMS!

 

Resuscitation table

Resuscitation table

photo 3

Patients

Patients

photo 2

 

 

 

 

 

 

 

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:

 

Screen Shot 2014-04-19 at 12.05.01 PM

 

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.

 

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!

How to Set-up a Pressure Transducer

Joe asked me to cross-post this video here from the EMCrit Site. Every doc and nurse should be able to set one of these up in <2 minutes for rapid arterial and central venous pressure monitoring.

 

Steven Bernard on the CHEER Trial from Intensive Care Network

The amazing blog and podcast: Intensive Care Network run by Oli Flower and Matt Mac Partlin recorded this lecture by Steven Bernard talking about the CHEER Trial of ECPR.

Dr. Bernard's Slides

Now on to the Lecture…