53b: Resuscitationist Inserted Distal Perfusion Catheter with Chris Couch

 

In this episode, we again explore the world of the distal perfusion catheter.  You heard from Joe Dubose the vascular surgeons point of view; now let's see how non-surgeon resuscitationists are dealing with this problem.  You will hear from Chris Couch, a critical care trained emergency physician from Dallas Texas and his colleague Omar Hernandez who have some novel thoughts and experiences related to when and how we insert these catheters.  You will hear about checking compartment pressures, poor man's way to “fluoro” your catheter, and much more.

 

Great summary of supporting literature – DPC Lit Search

 

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Trent Wray - ED/intensivist
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Trent Wray - ED/intensivist

These last two podcasts have been great discussions. The subject of whether all patients need a distal perfusion cannula was lightly discussed on the last podcast. I agree that most eCPR patients (not all) will tend to need one, particularly if they don’t wake up immediately and you can’t follow an exam. At my institution (the University of New Mexico) we do a fair number of awake cannulations in the ED and the ICU; particularly in patients with massive PE’s. We do primary VA ECMO for them (we try to avoid thrombolytics and intubation), and they often go from arrest/peri-arrest… Read more »