mechanical ventilation... its not thats complicated, lets not make it needlessly painful...
#StoweEM20 by @SkylerLentz Image
measure pt and use 6-8 cc/kg. @mdcalc formula for ETT depth & TV.
#StoweEM20 by @SkylerLentz ImageImageImage
different shops prefer pressure or volume. either is fine, just monitor how you’re doing.
#StoweEM20 by @SkylerLentz ImageImage
know your patient’s minute ventilation & track it. get a sense of how much minute ventilation different patients need. #StoweEM20 by @SkylerLentz ImageImage
hyperoxia is probably dangerous. as soon as the intubation is finished, cut back on the oxygen (esp neuro patients)
#StoweEM20 by @SkylerLentz Image
plateau pressure is the sum of all pressures! #StoweEM20 by @SkylerLentz ImageImage
plateau is what the lung (alveoli) feels. easiest to check inmediately after intubation (pt must be passive on ventilator). one more reason to use rocuronium 🤣 #StoweEM20 by @SkylerLentz ImageImage
use the plateau pressure to sort through high peak-pressure alarms. #StoweEM20 by @SkylerLentz ImageImage
take-home points. remember not to worry too much about the blood gas (ie permissive hypercapnia).
#StoweEM20 by @SkylerLentz Image

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More from @PulmCrit

Oct 26
Critical interactions for the critical care cardiologist: An anthology of the tortured pharmacist's department

- @TaniaAhuja at #critcarecards24 Image
@TaniaAhuja who should get AV nodal blockers?

Diltiazem is contraindicated in shock.

**If you don't know the EF, may avoid.**

Diltiazem and riveroxiban may interact as well.

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@TaniaAhuja diltiazem plus riveroxiban interaction may increase bleeding

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Low slow and trying to crash

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Getting things done is tough! A really sick CCB/BBl intoxication challenges this.

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@emcrit Start with calcium, although it probably don't do a ton. May follow this with a calcium infusion if there is sufficient IV access.

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@emcrit Intubate early before hemodynamics truly fall apart.

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No solid evidence that this was the correct approach.

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Volume loading may help push patients into the RV death spiral.

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cutoff may depend on context

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how to place a consult: you MUST understand the five stages of consultant grief.

once you can understand this painful and natural process, requesting consults will make a LOT more sense

buckle up, it can be a little rough…

🧵 1/6…
stage 1: denial

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