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In this part 2 of our 2-part podcast series on CardiacArrest - The When, Why & How, we discuss some of the finer art of cardiacarrest care and answer questions such as: how should we best communicate to EMS, the ED team and the family of the patient to keep the team focused, garner the most important info and keep the flow of the code going?
On arrival, the patient was in shock, was intubated, and had an immediate cardiacultrasound. What does a heart look like on ultrasound when the EKG looks like that? Here you go: It's not the world's greatest cardiacultrasound video, but it does appear to show poor function and low volume. How would you treat?
Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. If cardiacarrest from hypokalemia is imminent (i.e., It would be difficult to get a nurse to give it faster! As I indicated above, in our cardiacarrest case, after pushing 40 mEq, the K only went up to 4.2
On arrival in the ED, a bedside ultrasound showed poor LV function (as predicted by the Queen of Hearts) with diffuse B-lines. I'll never forget when I ordered such an infusion in 1991 and then my patient started seizing and I looked up and the nurse had hung the lidocaine wide open! Initial BP was 120/96, HR 102, SpO2 98%.
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