Discover and read the best of Twitter Threads about #smacc

Most recents (3)

How to Kill an Asthmatic by
@CriticalCareNow

35M asthmatic hx mult intubations

Nebs and Mg and steroids but no better.
#SMACC
Waiting for Heliox...and waiting.

Pt. says "I'm going to die. Intubate me."

Difficult intubation, 4 attempts.
Get the tube, then arrests.
Extended code, then called.
#SMACC
Epinephrine.

No one with asthma should have been intubated without getting epi.
#SMACC

This is a great great drug and everybody needs to stop being afraid to give it.
Read 12 tweets
Here is this week's @WellingtonICU #Twitterjournalclub prepared by Rosanna Rahman. We are so committed, we don't even stop for #SMACC
thelancet.com/journals/lanre…
Patients with acute hypoxemic respiratory failure (PaO2:FiO2 ratio ≤300mmHg) frequently require intubation in the intensive care unit.
Rapid sequence intubation (RSI) in the acute setting is associated with a high risk of life-threatening complications. Severe hypoxaemia (SpO2<80% for ≥5sec) occurs in 20-25% of patients and is associated with hypoxia-driven cardiac arrest.
Read 21 tweets
Assessment of Fluid Overload and Hypervolemia (1/8)

Clinical assessment and signs for #FO are aspecific and unreliable:
-pitting edema
-ascites
-positive fluid balance
-orthopnea
-hepatojugular reflux
-...

Preparing for #smacc #ISICEM19 #IFAD2019 #WCACS2019
Assessment of Fluid Overload and Hypervolemia (2/8)

Biochemical Assessment for #FO is aspecific and unreliable:
-Hypoalbuminemia
-Hypoproteinemia
-low COP
-low osmolality
-...

Preparing for #smacc #ISICEM19 #IFAD2019 #WCACS2019
Assessment of Fluid Overload (FO) and Hypervolemia (3/8)

Radiological and #POCUS imaging and signs for #FO are aspecific and unreliable:
- Absence of #IVCC
- Kerley-B lines
- Lung ultrasound B-lines
- Pleural effusions

Preparing for #smacc #ISICEM19 #IFAD2019 #WCACS2019
Read 7 tweets

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