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Have you ever wondered about how initiating ECMO changes the cardiovascular physiology? Have you wondered what metrics you should be looking at when resuscitating a patient that has a beating heart and a ECMO flow? Dr. Sage Whitmore, an ED Intensivist from Nashville with ECMO training from UMichigan, leads us through the basic to the tough question…
 
Have you ever wondered how you would crash someone onto VV ECMO? Have you ever wondered where is the best place to put the cannulas? Have stayed up late at night wondering which patients in your department could benefit from VV rather than VA ECMO? Then this is the episode for you!! After a few recent cases of crash VV ECMO in our hospital, we have…
 
This month we tackle a number of topics. Garrett Sterling is back again with Zack to talk about cutting edge resuscitation, ECMO, and the interplay between the two. Dual sequential defibrillation, CT after ECMO initiation, should you perform bystander CPR in the era of Covid, some US ECMO data, and an awesome 3D modeling for ECPR training models. A…
 
Aortic Dissection is a contraindication for ECMO….or is it? In this episode, Zack Shinar and Garrett Sterling discuss the sticky topic of ECMO for aortic dissection. They discuss a recent case where Joe Bellezzo, Karl Limmer, Craig Larsen, and the entire Sharp team save a Type A aortic dissection with cardiac arrest. Zack and Garrett traverse the d…
 
“Normal life is changing. It is now a covid 19 life” – Bin Cao I write this with some trepidation as well as pride in the role we all get to play in Covid 19. The sure in the US and many other places worldwide is just beginning. It is on us to seek guidance from those who have gone through this already. Today we will address the use of ECMO in Covi…
 
This month we discuss two different topics we’ve recently had on the podcast. Albuquerque had started the first US prehospital ECPR program…. and now they have the first patient as well. Jon and Darren will share with us the exciting news. Second, we recently had Matt Martin on the podcast talking about partial REBOA. We got tons of email about thi…
 
The U.S. has seen pre-hospital programs spring up in Paris, UK, and Australia. It was thought that due to billing issues this could never happen in America….but it has. Jon Marinaro and Darren Braude have accomplished this against all odds. Zack interviews the two of them on how they were able to accomplish this task amidst the many financial, logi…
 
Over the last two years, partial or intermittent REBOA has beenthought to be a significant advantage over complete REBOA. How to do this and how to use our current imperfect catheters in this arena is still in question. Matthew Martin and his colleagues at Madigan Medical Center have published the first study using the Prytime's new catheter for pa…
 
A post arrest patient just got initiated on ECMO. Do you give fluids, add pressors, or increase flow? Marc Dickstein, an anesthesiologist from Columbia University and an expert in the physiology of ECMO, talks with Zack about how to manage these patients, what diagnostics we need and how to optimize your use of the machine. This talk is a must for …
 
Do you give heparin to your ECMO patients? Well, let's rethink this. This episode is All Things Anticoagulation! Zack talks with Troy Seelhammer, an intensivist from Mayo Clinic Rochester. He manages ECMO patients in his daily practice there. He has become a master of the subject of anticoagulation. He will talk about heparin, bilvalirudin, or mayb…
 
In this episode, Sacha Richardson talks with Zack about a problem common to all ECPR programs- how do we confirm the placement of the wires? During chest compressions and even in patients with a pulse, confirmation of which vessel you have cannulated can be difficult. Sacha shares some tricks and trips on how to get real time confirmation of the wi…
 
In this episode, we again explore the world of the distal perfusion catheter. You heard from Joe Dubose the vascular surgeons point of view; now let's see how non-surgeon resuscitationists are dealing with this problem. You will hear from Chris Couch, a critical care trained emergency physician from Dallas Texas and his colleague Omar Hernandez who…
 
Episode 53 is all about the distal perfusion catheter12. We are inserting a 15-19 Fr catheter into the femoral artery. This limits the flow of blood to the affected extremity. Many institutions have gone to mandatory distal perfusion catheters. This episode is all about those catheters - when, how, which, and where. Joe Dubose, the world reknown va…
 
We've all heard of therapeutic hypothermia. Some of us have heard of deep hypothermia for traumatic arrest. But what about deep regional hypothermia of brain for cardiac arrest! Zack interviewed Rob Schultz, a CT surgeon resident from Calgary who is doing research on deep hypothermia of the brain using some of the tactics that are utilized in opera…
 
You've heard of ECMO for cardiac arrest- utilizing a mechanical pump to aid in perfusion of the coronaries. What if you can't do ECMO? What if your resources are such that simply can't lug a 10 kilogram machine out into the field? Well, Jostein Brede may have something for you to consider. He and several other places worldwide are on the forefront …
 
This is part 2 of Transport of ECMO patients. Mikael Broman is one of the world's leaders on ECMO transport. He works at the Karolinska institute in Sweden and has and continues to publish in the arena of ECMO transport. As you will see, he offers a world of experience and certainly some critical information that we would all benefit from listening…
 
This month we are looking at how to transport patients from one facility to another on ECMO. This is difficult task full of potential catastrophes. Zack interviews Leon Eydelman, an ER/Critical Care physician from Chicago, and Michael Broman out of Karolinska in Sweden. Leon will be bringing us up to speed on what to do, potential fails, and how to…
 
n this episode, Zack Shinar interviews Zaf Qasim about the recent controversies with ACEP and ACS about who can do REBOA. Zaf is one of the world's experts on REBOA and he's an ER doc! Zaf works at the University of Pennsylvania, trained in Londonas well as Shock Trauma in Baltimore and teaches at Reanimate. When you come to the essence of this epi…
 
This part two of August 2018. We are now tackling the difficult question of when to transport cardiac arrests if I have ECMO available? Brian Grunau is an expert in this question. Brian has become a giant in the world of ECMO. His research, leadership and experience have pushed the Canadian ECPR contingency to the forefront. Brian gives us some ins…
 
Over this last year we have had episodes on organ donation and decision to transport. This month we are revisiting two topics with two amazing people in two separate episodes. Here, I interviewed Velia Marta Antonini. Velia works in Italy where several of the great ECMO donation papers have originated. She explains why this research is coming from …
 
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