We work in a multi-hospital system made up of multiple secondary community hospitals and one large quarternary facility downtown. Our community hospitals have a strong ICU team who routinely admit and manage patients with severe ARDS. They are capable of paralytics and proning but do not have access to ECMO. The questions we often struggle with are: who needs to transfer for ECMO? when do they need to transfer? how do we know who will end up being too sick to transfer? at what point should we make the phone call to the big house?
We sat down with our ICU director and our local ECMO guru to answer these questions. Tune in!
Read MoreThe consensus from our first virtual podcast club: Emcrit's Cardiac Arrest Update
Read MoreHemodynamic Classification of Acute PE (AHA)
Massive PE
- SBP <90 for 15 min or req. inopressor support
- OR Pulselessness
- OR Sustained HR <40, s/sx of shock
Definitions
- Paroxysmal - terminates spontaneously, without intervention in 7d (or has in past)
- Persistent - > 7 days
- Long-standing persistent - > 12 mo
- Permanent - cardioversion failed or never attempted
- Valvular - 2/2 rheumatic mitral stenosis, mechanical valve or mitral valve repair