Review our show notes as you listen to the podcast!
Michael Lauria, Paramedic and MS-1
MaineCrit traveled down to Hanover, NH
Scott Weingart's interview with Michael on Mental toughness.
John Greenwood's post about GRIT on IteachEM.
"New Med Students Training as EMTs"
SMACC Gold lecture on what works in education. The answer is yes. The answer is also no.
Full article: Mental Practice for Trauma Resuscitation http://t.co/k1zOBjPRt8#FOAMed@CJEMonline@ResusPadawan@EMSwami@Inject_Orange — Christopher Hicks (@HumanFact0rz) April 11, 2015
And finally, Dat library...
Just a small piece.
Shock: Inadequate perfusion at the cellular level.
“The rude unhinging of the machinery of life” ~
Adequate Perfusion requires:
- The Pump (heart)
- The Fluid (blood)
- The Container (vasculature)
- Air Exchange (oxygenation / ventilation)
- Adequate Cardiac Output
- Stroke Volume X Heart Rate (4-8L/minute)
- Affected by Preload, Contractile Force, and Afterload
- Volume of blood must fill container
- Vasculature is properly sized
- Pre and post capillary sphincters at local level
- O2 into lungs and circulation
- Elimination of CO2 and waste products
- Adequate FiO2 and ventilation
- Diffusion across alveoli / capillary membrane
- Adequate number of RBCs
- Efficient offloading to target cells
Stages of Shock
Types of Shock
- Primary Survey / ABCs
- C spine
- Major bleeding
- Supine / Keep warm
- IV, monitor
- Fluid challenge
- Epi / Benadryl (anaphylaxis)
- Chest decompression (tension pneumothorax)
- Pericardiocentesis (cardiac tamponade)
- Dysrhythmias (ACLS)
- Pressors (fluids first)
- Narcan (opiod OD)
Take Home Points
- Shock: Inadequate perfusion at the cellular level.
- If you think shock, your patient is already there.
- Know and treat the root causes.
- Set a target MAP.
- Be aggressive!