Burns, bubbling airways and bradycardic arrests: all part of this week's grand rounds that brought plenty of knowledge our way. This week we heard from Dr. Dale, burn surgeon, about the latest in burn management. Dr. Carleton ran through some of his hardest airway cases for an infallable mental model of intubation. Our R3s gave a practical session on transvenous pacer placement and Dr Kircher gave us his clinical soapbox of pneumonia management.
Read MoreWe used Part 1 and Part 2 in this series to give you an in depth understanding of all the critical steps of the procedure. After reading those posts you should have a good grasp of the indications for the procedure, the complications you may encounter, and you will have read, seen, and heard step by step instructions for placing a transvenous pacemaker in the ED. This final installment in the series should bring it all together for you. Here you will see the placement of the transvenous pacemaker from start to finish from the point of view of the operator (Dr. J'Mir Cousar) all filmed in glorious HD.
Read Moreworked to create a video walkthrough of the procedure. The video walkthrough is divided into two separate videos. The first, embedded below is a narrated procedural slide set, designed to be a cognitively unloaded approach to learning the procedure. In a later post we'll see a full, start to finish video of the procedure filmed from the first person viewpoint.
In addition to the video being posted here, Dr. Cousar has constructed a checklist that will be placed on the pacemaker generator which will have a QR code to link to this narrated slide set.
Read MoreIf you are interested in seeing the placement of a Transvenous Pacemaker after reading this post check out Part 2 (Procedural Slide Set) and Part 3 (the first person view of the procedure)
Reasons to Pace in the First Place
Hemodynamically unstable+
1. Sinus Bradycardia - seen in 17% of acute MI patients (especially inferior or anterior wall MI) [1,2]
2. AV Block - may be due to ischemia (15-19% of all Acute MI) [2,3]
3. Drug Overdose - with the goal of maintaining adequate hemodynamics while your medical therapy/dialysis has an opportunity to work.
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
