Intubating RV Failure

[@zakalobi80]

Very interesting. Short and useful message.

[@CriticalCareNow]

Thank you

[@scorpieo]

Great lecture, and btw funny cc lol! comedic at the end.

[@CriticalCareNow]

Thanks!

[@ha5mth]

Brilliant, succinct information. Thank you 🙏

[@CriticalCareNow]

Thank you!

[@andyiriza625]

Great video, i would suggest maybe there is another step to take here. I think we all agree no matter what you do intubating and transporting this patient is super high risk. Would it change your management, ie avoid both of those steps all together, if you find a dvt with bedside ultrasound? I would argue yes.

[@CriticalCareNow]

I might argue, possibly 😀

Great short video with critical information. Any tip/tricks for those of us working in a Critical Access Hospital and no access to diagnostics like UC/ECHO? I was thinking just straight to CT, but in terms of initial resuscitation, start a small bolus and the epi drip? Maybe even start with some push-dose epi?

[@CriticalCareNow]

Would definitely portion for echo if you’re going to see critically ill patients. Especially in a critical access hospital

[@tobiastemann8295]

One of the cases to still consider etomidate imo. Not to say Ket wont work... Also, if available in your settings and if in compliance with patient's will, consider awake vv or even va-ecmo.

[@CriticalCareNow]

Thanks

[@medschneverends]

Great stuff as always. Is there ever a role for diuretics in either this scenario or other exceptional cases?

[@CriticalCareNow]

Not acutely

[@hossammustafa3146]

Stabilize first make sense. Where is reperfusion therapy if the patient was hemodynamically unstable

[@CriticalCareNow]

Totally!

[@mikhailelfond7803]

what about goals of care discussion? DNR/I?

[@CriticalCareNow]

Always

[@DRALI-ig9jz]

wouldn't NIPPV worsen RV failure?

[@jonathanchigges7658]

Yes, the increased thoracic pressure will reduce venous return. These patients need ionotropic assistance and maximal oxygenation hence the low PEEP settings on the ventilator.

[@CriticalCareNow]

Yes. It may