Medic to medicine part 2, with Michael Lauria.

Cricothyrotomy, Training, and mental simulation.


Twitter references:

Minh Le Cong @ketaminh

Scott Weingart @emcrit

Cliff Reid @cliffreid

Anand Swaminathan @EMSwami

Social media

Last Mile Health


Thank you so much for listening! Stay tuned for more material from MaineCrit!

Medic to Medicine: Michael Lauria

Review our show notes as you listen to the podcast!

Michael Lauria, Paramedic and MS-1

MaineCrit traveled down to Hanover, NH

 to interview flight paramedic and MS-1, Michael Lauria(@ResusPadawan)

Toughness Part I with Michael Lauria

Scott Weingart's interview with Michael on Mental toughness.

The Importance of GRIT

John Greenwood's post about GRIT on IteachEM.

Hofstra North-Shore

"New Med Students Training as EMTs"

Victoria Brazil - Evidence-Based Education- What Works

SMACC Gold lecture on what works in education. The answer is yes. The answer is also no.

Mental practice: a simple tool to enhance team-based trauma resuscitation




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 Essentials in 8 Minutes

Shock:  Inadequate perfusion at the cellular level.

“The rude unhinging of the machinery of life” ~

Samuel D. Gross

Adequate Perfusion requires:

  1. The Pump (heart)
  2. The Fluid (blood)
  3. The Container (vasculature)
  4. Air Exchange (oxygenation / ventilation)

The Pump

  • Adequate Cardiac Output
  • Stroke Volume X Heart Rate (4-8L/minute)
  • Affected by Preload, Contractile Force, and Afterload

The Fluid

  • Volume of blood must fill container

The Container

  • Vasculature is properly sized
  • Pre and post capillary sphincters at local level

Air Exchange

  • 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

  • Compensated
  • Decompensated
  • Irreversible

Types of Shock

  • Hypovolemic
  • Cardiogenic
  • Distributive
  • Obstructive

Managing Shock

  • Primary Survey / ABCs
  • O2
  • BVM
  • C  spine
  • Major bleeding
  • Supine / Keep warm
  • IV, monitor

Specific Treatments

  • Fluid challenge
  • Epi / Benadryl (anaphylaxis)
  • Chest decompression (tension pneumothorax)
  • Pericardiocentesis (cardiac tamponade)
  • Dysrhythmias (ACLS)
  • Pressors (fluids first)
  • Narcan (opiod OD)

Take Home Points

  1. Shock:  Inadequate perfusion at the cellular level.
  2. If you think shock, your patient is already there.
  3. Know and treat the root causes.
  4. Set a target MAP.
  5. Be aggressive!

~Chip Getchell